HomeMy WebLinkAboutUtility Installation RequestUtility Installation Request Form 1082
(Rev. 1112006)
(GSD-EPC)
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To theTexasTransportation Commission Date _0_6_1_2_01_0_8 ______ _
c/o District Engineer
Texas Department of Transportation Bryan , Texas
Formal notice is hereby given that _M_ar_e_k_B_ro_th_e_r_s _c_o_ns_tr_u_ct_io_n..:._,_L_P ___ -:-------.,,..--:---::-:-:-::-::-:--------
proposes to place a 8" x 6" D.I. Tee, 8" Gate Valve, 6" D.I. Fittinq and +/-12 LF of 6" AWWA C900, CL200 PVC Pipe
line within the right of way of S.H. 30 , RM to RM in Brazos County
Texas, MNT Sec. No. as follows: (give location, length, general design, etc. Use additional sheet as needed)
The construction consists of the installation of a a· x 6" D.I. tee, 8" gate valve, 6" D.I. fitting and approximately 12 feet of 6" fire line
within the R.O.W. of S.H. 30 on the southeast side approximately 1,720 northeast of intersection of S.H. 30 and Linda Lane in
College Station, Brazos County, Texas.
We will construct and maintain the line on the highway right of way as shown on the attached drawing and in accordance
with the rules, regulations and policies of the Texas Department of Transportation (TxDOT), and all governing laws,
including, but not limited to, the "Texas Engineering Practice Act," "Federal Clean Water Act," the "National Endangered
Species Act,• "Americans with Disabilities Act," and the "Federal Historic Preservation Act." Upon request by TxDOT, we
will submit to TxDOT proof of compliance with all governing laws, rules and regulations before commencement of
construction. Plans shall include the design, proposed location, vertical elevations, and horizontal alignments of the facility
based on the department's survey datum, the relationship to existing highway facilities and the right of way line, traffic
safety and access procedures, and locatibn of existing utilities that may be affected by the proposed utility facility. The
location and description of the proposed line and appurtenances is more fully shown by a complete set of drawings
attached to this notice.
Our organization will use Best Management Practices to minimize erosion and sedimentation resulting from the proposed
installation, and we will revegetate the project area as indicated under "Revegetation Special Provisions."
Our organization will ensure that traffic control measures complying with applicable portions of the Texas Manual on
Uniform Traffic Control Devices will be installed and maintained for the duration of this installation.
When installing our utility on controlled access facilities, we shall conform to the Texas Transportation Code, Title 6
Roadways, Chapter 203, Subchapter C, Control of Access, §203.031 ( http://tlo2.tlc.state.tx.us/statutes/statutes.html.). We
shall limit access for servicing this installation to access via (a) frontage roads where provided, (b) nearby or adjacent
public roads or streets, (c) trails along or near the highway right of way lines, connecting only to an intersecting road; from
any one or all of which entry may be made to the outer portion of the highway right of way for normal service and
maintenance operations. Our rights of access to the through traffic roadways and ramps shall be subject to the same rules
and regulations that apply to the general public.
It is expressly understood that TxDOT does not purport, hereby, to grant any right, claim, title or easement in or upon this
highway; and it is further understood that TxDOT may require us to relocate this line, subject to the provisions of governing
laws, by giving thirty (30) days written notice.
We will notify TxDOT prior to commencement of any routine or periodic maintenance which requires pruning of trees within
the highway right of way, so that TxDOT may provide specifications for the extent and methods to govern in, but not limited
to, trimming, topping, tree balance, type of cuts, painting cuts and clean up. We understand that these specifications are
Intended to preserve TxDOT's considerable Investment in highway planting and beautification, by reducing damage due to
trimming and to protect known endangered species.
Our installation shall not damage any part of the roadway structure or associated appurtenances and we will make
adequate provisions to minimize inconveniences to the traveling public, and adjacent property owners. In the event we
fail to comply with any or all of the requirements as set forth herein, the State may take such action as it deems
appropriate to compel our compliance.
Following approval, we will begin construction on or after ___________ o_6_12_3_to_a _________ _
Month/Day/Year
Additional Provisions and Requirements (for TxDOT Input only)
•General S~eclal Provisions:
0 Are attached. I
C: Are not attached.
•As-built Plans/Certifications of Construction:
[j Are reguired and shall be certified as accurate b:t an authorized re2resentative of the com2any.
0 Are required and shall be signed and sealed by a State offexas Licensed Professional Engineer.
0 Are not required
[J Certification that utility was installed as approved
Fonn 1082
{Rev. 11/2006)
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• Re-vegetation Special Provisions: In order to minimize erosion and sedimentation resulting from the proposed
installation, the project area will be re-vegetated:
C in accordance with TxDOrs Standard Specification Item 164 which specifies teh appropriate grass seed mix
to be used, or:
0 as indicated on the attachment.
TxDOT Representative to be notified 48 hours prior to beginning construction
If approved, we understand that we will assume all risks associated with this Installation within the TXDOT right of way.
These risks include, but are not limited to, Injuries to our workers, damage to contiguous utility lines that may be in the area,
injuries or damage resulting from our failure to properly install and maintain the line as shown on pians.
We understand TxDOT may place additional provisions and requirements as listed above, based upon, but not limited to,
the type of utility being installed, local site conditions, soil types and traffic.
We acknowledge that this Utility Installation Request approval expires on the 91st calendar day from the date of issuance,
unless otherwise approved, if we do not begin our installation by this date. If we do not begin our installation within this
time frame and still wish to continue, we will resubmit our request in accordance with the prevailing governing laws, rules,
regulations and policies at the time of resubmission.
By signing as/for the requester below, I certify that I am authorized to represent the requester, that I agree to the provisions
and requirements included in this Utility Installation Request, and our commencement of construction will further attest to
our review and acceptance of said additional provisions and requirements.
REQUEST OR APPROVED BY TxDOT
Date: 06/19/08 Date:
By:
Signature:
Title:
Address: 2112 Southwood Drive Address:
College Station TX 77845
City State Zip Code City State Zip Code
979 696-5562 ( )
Area Code Telephone Number Area Code Telephone Number
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