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APPLICATION FOR WIRELINE CROSSING OR PARALLELISM OF PROPERTIES AND TRACK


Name of Applicant:
Telephone
Number:


Fax
Number:
Mailing Address:

FEIN
or SSN
Contact Name:

Email Address:
Preferred Courier:
UPS
Number:

Fed Ex
Number:

Overnight
Delivery Address:

Corporate Name:

State Incorporated:

Application For:
(Select Two)
(_)
Overhead
(_)

Underground
(_)
Wire Line Crossing
(_)

Wire Line Parallel to Track
(_)

Both
Wire Line Type:
(Select One)

(_)

Electric
(_)

Telephone
(_)

Fiber Optic
(_)

Cable TV
(_)

Other**
**Describe Other Type:

Proposed Date
of Installation:

Crossing Will Be
Used For:
(Select One)

(_)

Transmission
(_)

Distribution
(_)

Service

LOCATION

Railroad Name:

Nearest City:

County: State:

Railroad Subdivision:
Nearest Railroad Mile Post:
Distance and direction from
nearest Railroad Mile Post: Feet N S E W
Quarter, Section, Township and Range:
Is Crossing Within a Public
Road Right-Of Way?
(_)
Yes
(_)
No
If Yes, Name
of Road:

US DOT Railroad
Crossing Number:

Total Length of Wire on
Railroad Right-Of-Way:


Rail Property Management

INTERSTATE MANAGEMENT GROUP, INC.
P.O. Box 2475
Orange Park, FL 32067-2475
Phone (904) 264-1560
Fax (904) 264-1561 Page 2 of 3
WIRE LINE DATA
Size and Type of Wire or Cable:

If Parallelism, Distance of Wire Line Parallel to Railroad Tracks:
Angle of Wire Crossing the Track:
Degrees Number of Tracks crossed:

Total Length Within Railroad Right-Of-Way:
Height of Wire Above Top of Rail at 60
°
:

Sag in Spans at 60
°
:
Number of Electrical Conductors:

Voltage:
Phase:

Cycles:
Conductors:
Number:
AWG
Gauge:

Material:
Alternating Current:
Voltage:
Number of Phases:

Hertz:
Direct Current:

Voltage:
Amperes:
Maximum Voltage:

Maximum Current:
Maximum Fault to Ground Current:
Height of Wire Supports Above Ground Level:

Type of Wire Supports:
Size:

False Dead Ends:

Number of Poles to be Located on Railroad Right-of-Way:

Distance from Butt of Pole to Nearest Rail of Main Track:
Side Track:


UNDERGROUND WIRE LINE DATA
Encasement Material:

Length of Casing:

Casing Wall Thickness:

Outside Casing Diameter:
Number of Innerducts:
Innerduct sizes:

Base of Rail to
Top of Casing:

Ft In
Not Beneath
Tracks:
Ft In
Roadway
Ditches:
Ft In

Describe in detail the manner and method of installation on Railroad property:










EXISTING AGREEMENT
Is there an Existing Agreement at this Location with the Railroad Company, which will be effected by this Request?
(_) Yes
(_) No
If Yes, List Agreement Number:

Will Line Exclusively Serve Lessee of Railroad?
(_) Yes
(_) No
If Yes, List Name of Lessee:
Page 3 of 3
If this application is approved, applicant agrees to reimburse Railroad for any cost incurred by Railroad
incident to the installation, maintenance and/or supervision necessitated by the installation. Applicant
further agrees to assume all liability for accidents or injuries that arise as a result of this installation.

Plans for proposed installation shall be submitted to and meet the approval of the Railroad Company before
construction is begun. Material and installation are to be in strict accordance with specifications of National
Electrical Safety Code and AREMA, current edition, and requirements of the railroad.







For Mailing via U.S. Postal Service, send to:


Interstate Management Group, Inc.

P.O. Box 2475
Orange Park, FL 32067-2475
For Overnight Service via FedEx, UPS, etc., send to:


Interstate Management Group, Inc.
1546 Kingsley Ave.
Orange Park, FL 32073

Payment Instructions:


Make your check payable to:


Interstate Management Group, Inc., P.O. Box 2475, Orange Park, FL 32067-2475

It is recommended that any questions concerning this application should be submitted by email to
IMGapps@imgonline.net. All correspondence submitted by email receive priority response. Other
requests can be made by phone at (904) 264-1560.

Date:
Signature:
Phone
Number:
Printed
Name:
Fax
Number:
Title:

Contact Email Address: