HomeMy WebLinkAboutNorth Coast Railroad Authority - Application for Pocket Park 2002-09-06j~Cj? f 14,/o
NORTH COAST RAILROAD AUTHORITY
APPLICATION FOR:
Pipeline Lease Private Crossing
Commercial Crossing Temporary Use Environmental studies
Construction and maintenance
Access Permit Construction Other landscape area
Section "A" - Identity of Applicant:
1. Name of Applicant (If Corporation, give exactly as per Articles of Incorporation):
City of Ukiah
2. State of incorporation (If corporation or partnership, give names of all general
partners; if proprietorship so state): Municipal corporation
3. Name and Address of person or office to which future billing for rental or fees should
be sent: Larry DeKnoblou h, Communit Services Director, 300 Seminar
Ave. Ukiah CA 95482
4. Name and Phone Number of person to whom questions regarding this Application
can be directed:
5. If work is to be performed by a contractor or subcontractor other than Applicant
Give name, address and phone number of contractor or representative:
Please use the remaining space on this page to provide any additional information
about the Applicant and its contractors or subcontractors that will permit the Railroad
to contact, and stay in contact with, parties responsible for the design, implementation
and future maintenance of the work to be performed: The City of Ukiah is
intending to complete a small greenspace landscape area between
Perkins. Street, creek and the tracks J!roj t will be completed
through a combination of volunteer cit staff and contractors.
Volunteers and contractors h
The City will also be installing a free-standing monument style
entry sin on the site.
Section "B" - General Description of Project:
1. Give a general description of project, including the reason the work is necessary
and the parties to be served, names of proposed contractors and subcontractors,
etc: Construction of a greenspace "Pocket Park" along the Perkins
Street frontage. The City's goali& x,g;F,L,XgCLgcaRe and beautify
the Perkins Street entr into downtown. The City will also be
-nstallin a free-standing monument style sin on the site,
2. Is this a new installation, relocation, repairs or modifications to an existing
Installation? Give details: No
3. General location information: The site is bounded by the tracks
on the West, Gibson Creek on the south, Perkins Street on the
N..
North, and NBR on the east.
4. Was there an agreement or any correspondence covering this or a related project
with the Northwestern Pacific Railroad or other precursor company or
landowner? If so, give references or attach copies: N„
Date work scheduled to begin: September 2002
Estimated completion of work: October 2002
Date by which permits/licenses desired: August 2002
5. Please provide information as to type and amount of general liability insurance
carried or proposed, name of insurer or agent, and person to contact. Railroad
will generally require contractor(s) to provide $1 million unrestricted liability I
insurance and certificate naming Railroad as insured party must be received and
approved before work begins.
Please submit this Application with a cover letter on your firm's letterhead signed by an
authorized officer, and submit with three (3) copies of a sketch or prints clearly depicting
the proposed crossing or encroachment and its location.
Charges: Application fee of $250.00 is to be remitted with completed Application. A
one time initial fee, plus an annual license or encroachment fee will also be charged; this
is based on current NCRA policy. The fee will be specified in the license or
encroachment permit when issued. No work may begin on or over Railroad property
until the license or permit has been duly issued and the initial fees paid.
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Prior to start of any encroachment on any of the Railroads right of way, proper notice
must be given to the NCRA This due notice must be given a minimum of 72 hours prior
to the onset of any activity. In addition, any work activity encroaching within twelve
(12) feet of the Railroad right of way must comply with all state and federal railroad
safety and operational requirements as defined by applicable state and federal regulations,
including without limitation 49 CFR Part 214, and the Carrier's Contractor Safety
Requirements. It is incumbent upon the holder of this encroachment permit to contact the
Railroad to determine what if any railroad safety training, or operational requirements
must be met before any work can start. Most charges for Raolroad support services are
found in its published tariffs. Upon request, the holder of this encroachment permit will
be given an estimate of any other fees to be incurred.
Section "C" - Design Particulars of Proposed Line (s)
Commodity transmitted in pipeline:
Is commodity hazardous?.
PIPE DATA
Class and/or Wall Diameter Type Length
Thickness
Carrier Pipe
Casing Pipe
(Casing must have a 2" minimum clearance between greatest outside diameter of
carrier pipe and inside diameter of casing; when furnishing diameters give O.D.
of carrier and I.D. of casing.)
Depth of carrier pipe below natural ground:
Depth of casing (top of casing to bottom of rail):
Depth of casing (top of casing to sub-grade):
Maximum operating pressure:
Does casing terminate above ground? No end only
Both ends
Is casing vented: Describe vents (number, size, and height above
ground):
Type of material of carrier pipe elsewhere in line if different from undertrack
material. If open ditch, give depth, profile and lining information, and whether
debris screens or floodgates are used:
Proposed method of undertrack installation. If other than boring or jacking, a
detailed plan must be submitted and extra review time allowed.
Location of proposed pipeline crossing relative to nearest section line, measured
at right angles to the section line where pipeline will pass under
tracks: ft. from (l) (S) (E) (W) (Center) line of
Section- , TowhshiP Range
County or city street:
City of
Angle of pipeline crossing to track: degree
Minimum.
Additional description, location information, etc:
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Section "D" Insurance Information and Applicant's Signature:
The Railroad will ordinarily require Applicant and/or contractor(s) and subcontractor(s)
to provide liability insurance in an amount of at least $1 million before work commences
or any entry is made on or over Railroad property. In executing this Application,
Applicant acknowledges that it is aware of all requirements and agrees to procure
insurance and furnish certificate thereof, naming the Railroad as an additional insured or
co-insured under a suitable policy of insurance to cover all risks undertaken in carrying
out the proposed work on Railroad's property.
I hereby certify that this Application is made and signed by me as the duly authorized
officer or representative of Applicant, which agrees to pay the Application fee and all
railroad required fees established by the Carrier, and upon and after commencement of
the work described herein, the one time fee, and annual fees then or thereafter imposed.
After applicants plans have been approved by the Carrier's duly authorized agent or
engineer, all fees required by the Railroad have been paid, all safety and railroad
requirements identified by the Carrier have been met, and the application fee and the first
annual license fee paid, this form duly counter signed becomes the encroachment permit
and authorization to proceed.
7-le --c z__
App icants Signature Date
Candace Horsley City Manager
Print Applicant's Name Print Applicant's Title
NCRA
Fees: $ Application Fee
$ Prepaid Annual License Fee
$ One time Fee
FEES FOR ENGINEERING INSPECTION
Fees: $ Engineering Review Fee
$ 49 CFR 214 Roadway Worker Safety Training Fee
$ Other One-time Fees
Return to:
NCRA
P. O. Box 279, Cloverdale, CA 95425
Fax: 707.894.1595
Email: ncm@saber.net
Applicant Name City of Ukiah
Encroachment Approval
Date of Application 7L1 o2
p Z
No " r dat
Title
PA
Engineering revie
date
Title
* NOTE 72 hours notice must be given to NCRA at 707-892-1595 prior to
construction and/or access.
**All fees must be paid prior to construction.
Amount Paid $
Amounts due: $
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