Platte River Power Authority crossing agreement application

General information
Applicant’s legal name of company/municipality/person(s) who will own the crossing license (or licensed facility):*
State in which incorporated, if applicable:*
If not incorporated, name of owner or partner(s):
Name of contact of owner entity:*

First NameLast Name
Email of contact of owner entity:*
example@example.com
Phone number: *
Please enter a valid phone number.
Mailing address (corporate office):*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing address (local office):

Same as aboveDifferent address
Mailing address (local office):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contractor representative:

First NameLast Name
Phone:
Please enter a valid phone number.
Email address:
example@example.com
Proposed crossing description*
Proposed construction schedule (include start date and end date)*
A fully signed agreement MUST be in place before work begins

Applicants proposed facilities
Type of facility (select all that apply)*

UndergroundOverhead
Proposed facility*

Electric facilitiesTelecommunicationsGas pipelineWater pipelineOther/multiple
If other/multiple, please describe

Pipeline
Check all that apply

Gas pipelineWater pipelineOil pipelineOther
Length of pipe on Platte River property*
Inside diameter or pipe*
Pipe material
Specification and grade
Wall thickness
Maximum allowable working pressure
Type of joint
Coating
Proposed distance from Platte River facilities or other existing facilities:
Note: No excavation within 10 feet of any transmission pole.
Proposed minimum ground cover on Platte River easement or property:
Height above ground:
Cathodic protection plan:
Method of crossing (choose one)*

TrenchHorizontal directional drilling (HDD)Other

Electric facilities
Type of wires/cables*
Number of wires or cables*
Occupied conduits
Vacant conduits
Total conduits
Conduit size
Conduit type
Length of crossing
Proposed wire clearance over or under Platte River and other existing facilities fill in the blank feet over or fill in the blank feet under.
Method of crossing (choose one)*

TrenchHorizontal directional drillingOther

Telecommunications
Type of wires/cables*
Number of wires or cables*
Occupied conduits
Vacant conduits
Total conduits
Conduit size
Conduit type
Length of crossing
Method of crossing (choose one)*

TrenchHorizontal directional drillingOther
Proposed wire clearance over or under Platte River and other existing facilities fill in the blank feet over or fill in the blank feet under.

Document upload and final review

You will have an opportunity to review and print your full application before submitting.
Provide a detailed sketch that includes a detailed drawing of the proposed facility (e.g., water pipeline, gas pipeline, etc.), its orientation in relation to Platte River’s facilities and other existing facilities, excavation detail (if applicable), and any other pertinent detail. Sketch should show tie-down measurement to centerline of nearest road crossing, bridge or other railroad structure.

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Please verify that you are human*
Submitting an application does not guarantee approval as submitted. $250.00 of the application fee must be mailed, or wire transferred when the application is submitted. The remaining $750.is due with the fully signed agreement.

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General information