UTILITY CROSSING APPLICATION FORM - 2019

Applicant: ____________________________________________ Date: ________________

Description of Utility Crossing location:

City/Town: Lot: Concession/Legal Land

Desc.:

Township: County: Province:

GPS Coordinates of exact utility crossing: __________________ , -____________________

Name of Road that the utility is crossing CP tracks at: _______________________________

Railway Mileage & Subdivision if known:

Utility Owner Information:

Legal Name Of Utility Crossing Owner:

Address: _______________________________________________

City/Town: _ Postal Code: ________________

Contact/Signatory:

Phone: ( )

Email Address:

24HR Utility Emergency Response Number: ________________________________

Approximate start date of proposed utility installation work: ___________________ Number of days a CP flagman will be required for: (______) Days

Purpose of utility installation:

Does applicant have an existing pipeline, hydro/power/fibre line crossing over/under the

railway tracks at this exact location? Y/N

Does applicant have an existing permit / agreement in place for this existinginstallation? Y/N (Provide copy of document or CP file number)

Will existing utility be removed from the railway corridor? Y/N

Who owns the property where the utility i.e. pipe/cable/conduit/hydro line etc. crosses

the railway tracks? (Check off box beside the property owner.)Municipal_____, County ______, City______, Region_______, CP ___________.

If unknown, a property search should be conducted by Applicant to determine land ownership of

proposed utility crossing location. Not all Road crossings within the Province are owned by the local

Public Authority. Property limits should be shown on the drawing to avoid delays. Land ownership

determines whether your application falls under the permit or agreement processing fee schedule.

Drawing No.: Date:

Province:

UTILITY CROSSING FEES

Description Total cost

Utility Crossing Permits

Over/Under railway tracks and

crossing within

Regional/Municipal roads and

property not owned by the railway.

Application/Documentation &

Engineering review Fee

(Non-refundable)$400.00

One-Time

Permit Fee:

$575.00

$975.00 + taxes.

Utility Crossing

Agreements

Over/Under railway tracks &

crossing within Canadian Pacific

owned lands/right of way.

Application/Documentation &

Engineering review Fee

(non-refundable)$400.00

One-Time

Agreement fee:

$1,700.00

$2100.00 + taxes

Railway property/title searches $400.00 Non-refundable $400.00 + taxes

Utility searches and or copies of

agreements/permits $200.00/ea. Non-refundable $200.00 + taxes

Drawing Revisions (Substitution

of Prints) $400.00/ea. Non-refundable $400.00 + taxes

Additional Engineering review

fees $400.00 Non-refundable $400.00 + taxes

Assignments $400.00/agreement Non-refundable $400.00 + taxes

Typical utility crossing application turnaround 25-30 business days.

Express Fee*: (Permit/Agreements/Assignments issued within 10 business days):

Add $1,200 to Application/Documentation & Engineering Review Fee

above. Check off the box to the right if requesting this level of service:

Fast Track Fee*: (Permit/Agreements/Assignments issued within 5 business days):

Add $2,000 to Application/Documentation & Engineering Review Fee

above. Check off the box to the right if requesting this level of service:

*Express / Fast Track utility applications do not apply to installations that require Geotechnical review.

Above mentioned fees do not apply to utility crossings within major rail yards, or running

parallel within the railway right of way.

CP reserves the right to review these fees from time to time. CP does not grant easements for

utility crossings over/under the railway right of way.

Underground Pipe Crossing Information: Does CP Geotechnical Protocol apply to this pipe? YES/NO

Number of underground pipes crossing CPR tracks: ________

Material being carried in pipe i.e. storm, watermain, gas etc. __________________________

Depth below base of rail to top of steel casing pipe: __________ m Carrier: _________m

Depth below bottom of ditch to top of pipe: __________ m

Angle of crossing to the tracks: __________ (shall not be less than 45 degrees)

Number of tracks being crossed: ______________

Number of manholes within CPR property: _______________

Number of shut off valves within CPR property: _______________

Will existing pipe be removed or grouted in place: _____________________

Bridge Information:

Does pipe cross underneath a Railway Bridge: YES/NO

Depth below grade to top of steel casing pipe: ___________Meters

Distance from edge of bridge abutments to centerline of steel casing pipe: _________Meters

Distance from edge of bridge footings to centerline of steel casing pipe: ___________Meters Installation should not come within the Zone of Potential Influence or that of any part of a railway

bridge structure (footings, abutments, columns, piers, etc.). A cross-section of proposed installation

must be provided along with Engineers report if encroaching into these areas.

Pipe Specifications: Carrier Pipe (mm) Casing Pipe (mm)

Outside Diameter

Wall Thickness

Pipe Material

Specification & Grade

Type of Joint

Coating

Cathodic Protection

Specified Min. Yield Strength

Max operating pressure

Max operating temperature

Max surge & test pressure

Min. Operating Temperature

Vents: Are Both Ends of the pipe sealed (YES/NO)

Types of Seals:

Distance of shut off valves to closest track centerline: __________ meters

Distance from nearest point of sending/receiving pits to the nearest rail.

Sending pit: _________________meters. Receiving pit: __________ meters. Excavation pits should be placed outside the railway corridor and not come within 10m of the nearest

rail. If not practical, provide a detailed summary along with shoring/bracing design.

Method of installation: ________________________________________

Drawing No. _____________________ Date: __________ Steel casing pipe to conform to E80 railway loading and must span the complete railway right of way

width.

Drawing No.: Date:

Aerial/Underground Wire Crossing Information:

Aerial Information:

Number of new hydro wires / power lines crossing over the tracks: ______Hydro/power , _____(neutral)

Number of existing hydro wires / power lines crossing over the tracks: ______________

Number of new cables crossing over the tracks: _________

Maximum voltage/kv of proposed hydro/power crossing: _______________________

Height above top of rail to proposed installation: ______________Meters

No cable/wire shall be less than 7.6m from top of rail to lowest wire including sag.

If crossing within railway yards lowest wire with sag should not be less than 10m from top of rail.

Number of poles being placed within CPR property: __________ (Property plan must be shown.)

Pole Owner: _________________________________________

If not the Pole Owner, does your company have permission/permit to use these poles: (provide permission

document)

Number of cabinets within Railway property: _______

Number of guy wires within railway property: ______

Angle of crossing to the tracks: ___________ (should not be less than 45 degrees)

Number of tracks crossed by installation: _______

Drawing No. __________________

Underground Cable/Wire Crossing Information:

Number of wires/cables within the conduit/casing crossing under the tracks: _________.

Type of wires/cable crossing underneath the tracks i.e. fiber, hydro etc. _____________________________

Number of manholes, cabinets on railway property: ______ If fibre optic cable duct, Fibre Count: _______Provide material specification of casing pipe/conduit i.e. HDPE, PVC etc. _____________________________

Depth below base of rail to top of conduit/casing: ________m (must not be less than 1.52m)

Conduit outside diameter: ____________mm Wall thickness: ___________mm

Steel casing pipe outside diameter: ______________mm Wall thickness ________mm

Distance from nearest point of sending/receiving pits to nearest rail.

Excavation pits should be placed outside the railway corridor and not come

within 10m of the nearest rail.

Sending pit: _________m Receiving pit: _______m m

Method of installation: Jack & Bore, Directional drilling etc.

____________________________________________________________________

Bridge Information :

Does conduit/pipe cross underneath a Railway Bridge: YES/NO

Depth below grade to top of casing pipe: ___________Meters

Distance from edge of bridge abutments to centerline of conduit/casing pipe: ___________Meters

Distance from edge of bridge footings to centerline of conduit/casing pipe: _____________Meters

(Installation should not come within the Zone of Potential Influence or that of any part of a railway bridge

structure (footings, abutments, columns, piers, etc.) A cross-section of proposed installation must be

provided along with Engineers report if encroaching into the zone.

Drawing No.: Date:

UTILITY PACKAGE

Please include:

CP Utility Application Form

1 drawing to scale and stamped, plus 3 copies (11 X 17 in color preferred).

Complete installation should be shown on 1 drawing with plan view, profile and cross-

section along with an aerial image showing exact crossing location with a solid red line

across the rail corridor. (see attached examples) Please do not forward full contract

drawings.

Geotechnical report if pipe diameter is 300mm and larger. Ensure items 10.4 to 10.12

within table 2 of the Geotechnical protocol checklist are addressed and the track

settlement monitoring plan is within the report being submitted in order to avoid

delays. 1 copy of the complete report is to be sent to CP Geotechnical service provider.

Cheque made payable to Canadian Pacific and addressed to Utility Supervisor below,in the amount of $400 plus taxes to cover the Non-refundable Application/Documentation & Engineering Review Fee. The One-Time Permit or Agreement Feewill be invoiced once the document is fully executed. If unsure of payment process,send email to Utility Supervisor.

Insufficient information will result in review delays and additional review fees. No permit/agreement will be processed unless cheque is attached to application.

Utility applications sent by e-mail will not be reviewed.

Send complete package to one of the following addresses:

Eastern Canada (MB, ON, QC)

CP Engineering – Projects & Public Works

Jack Carello – Manager Utilities & Flagging

Canadian Pacific Railway

1290 Central Parkway West, Suite 800

Mississauga, ON L5C 4R3

Western Canada (BC, AB, SK)

CP Engineering

Graeme Dales – Supervisor, Utilities & Flagging

Canadian Pacific Railway

7550 Ogden Dale Road SE, Building # 1

Calgary, AB T2C 4X9

I have verified all required information and payment are being provided with this application and understand any missing items will result in delays to my application.

Revised February 25, 2019