GRANT COUNTY

APPLICATION FOR PERMIT

PUBLIC UTILITY/PIPELINE & OTHER CROSSINGS

REVISED AND EFFECTIVE AS OF FEBRUARY 4, 2008

TO: THE BOARD OF COUNTY COMMISSIONERS – GRANT COUNTY
112 EAST GUTHRIE, ROOM 104
MEDFORD, OKLAHOMA 73759
TELEPHONE: 580-395-2214 FAX: 580-395-2603

The undersigned or petitioner requests permission to establish or construct the following

described Public Utility or Pipeline Route or Other Crossings as described below and in
accordance with the provisions as listed below.

Describe route below and use GRANT COUNTY ROAD CROSSING PLAT OR A PLAT
showing approximate distance to Section Line or ¼ Corner. In the event of parallel routes show
distance to Section Line.

1) Applications for road crossings must be submitted to the Gant County Clerk no later
than five (5) days before a meeting of the Grant County Board of Commissioners
with a check for $500.00 per crossing made payable to Grant County Commissioners.
2) All telephone companies and public utility companies shall be exempt from the
inspection fee, but still must file an application with the Board of County
Commissioners. The petitioner/contractor SHALL call__________________ forty-
eight (48) hours prior to actual construction, so the inspector from Grant County can
be at the site during construction.
3) Blasting is not permitted within the County right-of-way, except in unusual
circumstances, and only with special, prior approval from the Grant County Board of
County Commissioners.
4) In constructing utility, pipelines or other routes that cross County Highways or Roads
NO DITCH OR TRENCH shall be opened by the petitioner/contractor. All crossings
shall be BORED and cased unless either is waived by the respective District County
Commissioner PRIOR to the submission of this permit for approval from the Board
of County Commissioners. (Use “Addendum A” to apply for waiver.)
5) When paralleling the roadway, lines shall be located within one (1’) foot of the R/W
line or the fence line, if a fence is in place. If no fence exists the R/W line shall be
located by an Oklahoma Registered Land Surveyor at the petitioners’ expense. A
copy of said survey shall be provided to the Board prior to granting a permit. In no
instance shall any line be placed within the limits of the roadbed. All underground
parallel installations shall be a minimum of forty-eight (48) inches deep from the

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 bottom of the ditch. All overhead parallel installations shall not cross any point of
access to the county road at a height of less than eighteen (18) feet.
6) The Petitioner agrees to erect any overhead lines to the clearance height and other
rules of construction, as prescribed by the Corporation Commission of the State of
Oklahoma.
7) All Section Corners and ¼ Sections Corners shall be protected, no utility, pipeline, or
other lines shall cross an intersection diagonally and no lines shall cross within fifty
(50) feet of a ¼ Section.
8) The Petitioner agrees to keep the road open to traffic unless otherwise agreed to or
approved by the Board of County Commissioners of Grant County.
9) Petitioner will move or lower said utility line, pipeline, or other lines if and when it
interferes with highway construction or maintenance, upon notice from the Board of
County Commissioners at said Petitioners expense.
10) All underground crossings shall be a minimum of four (4) feet below the elevation of
the bottom of ditch line or as required by District Commissioner. High pressure line
crossings shall be a minimum of four (4) feet below the elevation of the ditch AND
covered with a concrete slab from R/W to edge of roadbed.
11) Petitioner agrees to increase by one (1) wall thickness all steel pipes and all other pipe
will be sleeved (cased) at each road crossing and extend from R/W to R/W.
12) The Petitioner agrees to hold free and blameless Grant County for any damage to
persons or property caused by construction or maintenance of any poles, posts, stub,
pipes, valves, wires and other property placed on or under said roadway, pursuant to
this permit. Petitioner further agrees to be responsible for repairing all damages to
the roadway caused by the petitioner/contractor’s construction. This responsibility
includes, when and where appropriate.
13) Petitioner assures that all necessary permits have been received from those
governmental agencies from with approval is required by Federal of State Laws.
14) Effective February 4, 2008 there will be a $500.00 penalty for failure to comply and
the crossing will come into compliance within 21 days. Failure to come into
compliance within the 21 days a $500.00 per day penalty will be assessed until
compliance is met. Additionally, no other Permit Crossings will be approved.
15) Failure on the part of the petitioner to comply fully with the rules herein stated shall
cause the petitioner to forfeit his/her right to easement on said county R/W, as per
O.S. 69 §1401 April 20, 2004.

SUBMITTED BY:

PETITIONER: ___________________________________ DATE: _________________

MAILING ADDRESS: ____________________________________________________

TELEPHONE: _________________________ FAX: ____________________________

SIGNATURE: ___________________________________________________________

REVISED AND EFFECTIVE AS OF FEBRUARY 4, 2008

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Approved (or denied) on this ______ day of ________________________, __________.

BOARD OF GRANT COUNTY COMMISSIONERS

__________________________________________
Chairman

__________________________________________
Vice-Chairman

__________________________________________
Member

ATTESTED:

________________________________
County Clerk

FINAL APPROVAL/INSPECTION:

Approved/Inspected by__________________________________ Date: __________

COUNTY HIGHWAY OFFICE

Location/Remarks:________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

REVISED AND EFFECTIVE AS OF FEBRUARY 4, 2008

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 “ADDENDUM A”
TO GRANT COUNTY APPLICATION
FOR PUBLIC UTILITY/PIPELINE & OTHER CROSSINGS

TO: GRANT COUNTY COMMISSIONER – DISTRICT # _____________________

ADDRESS ________________________________________________________
CITY ____________________________________________________________
STATE ____________________________________ ZIP ___________________

The undersigned or petitioner requests a waiver as listed below to be attached to the original
application for permission to establish or construct the following described Public Utility or
Pipeline Route or Other Crossing as described below and in accordance with the provisions as
listed in the original application.

Describe route below and use GRANT COUNTY ROAD CROSSING PLAT OR A PLAT
showing approximate distance to Section Line or ¼ Corner. In the event of parallel routes show
distance to Section Line.

Special Request

SUBMITTED BY:

PETITIONER: ___________________________________ DATE: _________________

MAILING ADDRESS: ____________________________________________________

TELEPHONE: _________________________ FAX: ____________________________

SIGNATURE: ___________________________________________________________

Approved (or denied) on this _______ day of ____________________, _____________.

Grant Count Commissioner District # ____ __________________________________

Signature

REVISED AND EFFECTIVE AS OF FEBRUARY 4, 2008