Permit Number              Control Sample Contracts

UTILITY RELOCATION AGREEMENT PERMIT SUPPLEMENT
Permit Number Control • August 5th, 2013

Data Carrier Pipe Casing(If Used) Contents to be handled Pipe Material Specification & Grade of Pipe Outside Diameter (inches) Dimension Ratio (DR) for Non-Metallic Pipe Nominal Pipe Size (NPS) (inches) Wall Thickness(inches) Specified Minimum Yield Strength (SMYS) (PSI) Hydrostatic Design Basis (HDB) (PSI) for Non-Metallic Carrier Pipe *Maximum Allowable Operating Pressure (MAOP) (PSI) Surge Pressure Allowance (PSI) for Pipe Carrying Liquid Class Location Type of Joint (welded, mechanical, etc.) Method of Installation(bore, open cut, horizontal directional drilling, etc.) Location (crossing or parallel) and Crossing Angle if crossing Minimum Depth beneath roadway surface (feet) Minimum Depth beneath ditches or drainage structures (feet) Pipe Vertical Deflection by Spangler Equation (inches) Coating Material Cathodic Protection

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UTILITY RELOCATION AGREEMENT PERMIT SUPPLEMENT
Permit Number Control • August 5th, 2013
UTILITY RELOCATION AGREEMENT PERMIT SUPPLEMENT
Permit Number              Control • May 28th, 2015

Data Carrier Pipe Casing (If Used) Contents to be handled Pipe Material Specification & Grade of Pipe Outside Diameter (inches) Dimension Ratio (DR) for Non-Metallic Pipe Nominal Pipe Size (NPS) (inches) Wall Thickness(inches) Specified Minimum Yield Strength (SMYS) (PSI) Average Temperature of Transmittant Hydrostatic Design Basis (HDB) (PSI) for Non-Metallic Carrier Pipe *Maximum Allowable Operating Pressure (MAOP) (PSI) Surge Pressure Allowance (PSI) for Pipe Carrying Liquid Class Location Type of Joint (welded, mechanical, etc.) Method of Installation(bore, open cut, horizontal directional drilling, etc.) Location (crossing or parallel) Crossing Angle (if crossing highway) Minimum Depth beneath roadway surface (feet) Minimum Depth beneath ditches or drainage structures (feet) Pipe Vertical Deflection by Spangler Equation (inches) Coating Material Cathodic Protection

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