Back to Instructions		Calhoun County
Back to Engineer's Office		Permit No. _________________________
Application for Approval of Underground Construction
on Calhoun County Right-of-Way.
Applicant:
________________________________________________________________________________
Name of Individual or Company
________________________________________________________________________________
Address
Incorporated under the laws of the State of__________________________with principal place of business in
________________________________________________________________________________
City	State
		Date_____________________________________________
Calhoun County Board of Supervisors,
Rockwell City, Iowa
Gentlemen:-
Approval is hereby requested of underground construction of ________________________________________________________
		(describe fully work contemplated)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Plat of proposed underground construction showing location and other
pertinent information, shall be attached to each copy of the application.
The proposed line will be located________________miles________________________________from_________________________________________more
	(direction)	(place, town, etc.)
Specifically described as follows:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
AGREEMENTS: The applicant agrees that the following stipulations shall govern under this permit:
1. All trenches constructed longitudinally along the road shall be placed not closer than________________________ feet from the edge of the
pavement, or not closer than_________________________________ feet from the centerline of unpaved highways.The applicant will at any time
subsequent to placing the cable, pipe line, tile line, or stockpass, and at his own expense, relay, reconstruct or encase his lines as may
become necessary to conform to new grades, alignment or widening right-of-way, resulting from maintenance or construction
operations by the County irrespective of whether or not additional right-of-way is acquired in connection with such highway improvement.
The applicant agrees to do this promptly on order by the Board of Supervisors, and without cost to the County. If the applicant is unable
to comply promptly, the County may cause the work to be done, and the applicant will pay the cost thereof upon receipt of statement.
2. The County will endeavor to give the applicant sufficient notice of any proposed construction or maintenance work, on either
existing or newly acquired right-of-way, that is likely to expose, cover up, or disturb any cable, pipe line, tile line, or stockpass
belonging to the applicant, in order that the applicant may arrange to protect his lines. The County will inform contractors,
and others working on the job, of the location of the lines so that reasonable care may be taken to avoid damaging the lines.
The County assumes no responsibility however, for failure to give such notice.
3. The County assumes no responsibility for damages to the applicant's property occasioned by any construction or maintenance
operations on said highway, including new or additional right-of-way acquired in connection therewith,subsequent to the building of
the said pipe line, conduit, tile line, or stockpass.
4. The applicant shall take all reasonable precaution during the construction of said cable, pipe line, tile line, or stockpass to protect
and safeguard the lives and property of the traveling public and adjacent property owners and shall save the County harmless
of any damage or losses that may be sustained by the traveling public or adjacent property owners on account of such construction
operations. (See Note Below).
5. Operations in the construction and maintenance of said cable, pipe line, tile line, or stockpass shall be carried on in such a way as to not interfere with, or
interrupt traffic on said highway.
6. The applicant shall hold the County harmless from any damage that may result to said highway because of the construction or maintenance
of said cable, pipe line, or tile line, and shall reimburse the County for any expenditure that the County may have to make on said highway,
on account of said applicant's cable, pipe line, tile line, or stockpass having been constructed thereon.
7. The applicant agrees to give the County forty-eight hours' notice of its intention to start construction on the highway right-of-way. Said notice shall
be made in writing to the County Engineer.
8. Cable, pipe line, tile line, or stockpass crossings shall be constructed as follows: Water mains 2" or less inside diameter shall be copper, lead or
cast iron. Water mains of more than 2" inside diameter shall be cast iron and be encased. The casing shall be of adequate strength and of sufficient
length to extend 2' beyond the edge of the shoulder line. Pressure sewer lines shall meet the same requirements as water mains. Gravity sewer
lines and tile lines shall be cast iron pipe or an approved extra strength pipe and need not be encased. Underground telephone and electric cables
shall be installed in a casing. Natural gas service lines and mains in town distribution systems need not be encased except as may be required
of (9) below. On paved roads, cables, pipe lines and casings may be placed through the subgrade by jacking, or by boring a hole just large
enough to take the line; or if the County Engineer approves, a tunnel may be dug through and the cable pipe, line casing or stockpass placed therein.
On roads not paved, an open trench may be dug and the cable, pipe line, tile line, or stockpass placed therein, and the trench backfilled over the line.
All backfill of tunnels and trenches shall be thoroughly compacted in layers of 6" or less in depth. All work shall be done in a work-manlike manner,
and the ground left in a neat condition satisfactory to the County Engineer.
9. Pipe lines conveying gas, natural or artificial, oil, gasoline, motor fuel or other inflammable substances under and across primary roads, shall be
installed in accord with rules of the Iowa State Commerce Commission and American Standard Transmission and Distribution Piping System requirements.
10. This permit is subject to any laws now in effect or any laws which may be hereafter enacted.
11. This application is subject to revocation by the Board of Supervisors at any time, when in the judgment of the Board, it is necessary
in the improvement or maintenance of the highway or for other reasonable cause.
RECOMMENDATIONS
Recommended for Approval:		_________________________________
		Name of Company
By _________________________________________		By __________________________________
County Engineer		Name	Title
Date________________________________________		Address___________________________________________________
		Date _____________________________________________________
			APPROVAL OF BOARD OF SUPERVISORS
			CALHOUN COUNTY, IOWA
		_________________________________________
		Chairman, Board of Supervisors
(3 copies of the application and plat must be filed with the County Engineer, Rockwell City, Iowa, for each underground construction project on County right-of-way.)		_________________________________________
		_________________________________________
		_________________________________________
Note 4a
The applicant shall be responsible for all traffic control signing as per I.D.OT standards or as approved by the County Engineer. See attached I.D.OT Standards RS-2, RS-3, and detail sheet 520-26(A). Calhoun County will furnish the signs to be picked up and returned to the Rockwell City Shop.
Calhoun County ROW contains GPS Monuments set on a 3 mile grid. Applicants shall not disturb/damage said Monuments