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✓ <br /> INITIAL NOTIFICATION OF INTENT TO CONSTRUCT PIPELINE CROSSING/ENCROACHMENT <br /> Complete this form and return it along with a COPY OF YOUR PLAT,LEGAL DESCRIPTION AND DETAILED <br /> CROSS SECTIONS and a non-refundable preparation fee of$750 made out to CN. <br /> DATE: November 16 2007 <br /> 1. Owner/Applicant Information <br /> Name and Address: �ity cf Decatur, One Cary K. Anderson Plaza, Decatur, IL 62523 <br /> Authorized Representative: Mattnew c. Newell Title City Engineer <br /> Phone Number: (2i�)424-2�4� Fax Number (217)424-2799 Emailmcnewell@decaturnet.orQ <br /> 2. Location Of Pipeline <br /> Pipeline Location Mile Post: �4�.00A plus zso' soutn feet (if <br /> parallel) to M ile Post: plus feet <br /> At or Near Elwin, Illinois 295442 J (Name of City, Town, Village) <br /> 3. Commodity to be transmitted in pipe line: water <br /> (steam, air,water, gasoline or other petroleum products, chemical-specify: natural or artificial gas. If sewer, identify <br /> as to force or ravit line, sanita , storm or chemical waste—s eci <br /> 4. Pipe Data <br /> CARRIER PIPE CASING PIPE <br /> A. Inside Diameter: 12.3s" 23_35" <br /> B. Outside Diameter: 13.20" 24.00" <br /> C.Wall Thickness: 0.31" o.37s" <br /> D. Pipe MateriaL• Ductile Iron Steel I <br /> E. Specification/Grade or class: PC 35o gg <br /> F. Min.Yield Point of Material --- 35,00o Ps1 <br /> G. Process of Manufacture Centrifugally Cast --- <br /> H. Name of Manufacturer N•A• N.A. <br /> I. Type of Joint Field Lok Gasket Welded <br />' J. Working Pressure 55 PSI N.A. <br /> K. Maximum operating pressure in pipeline: 60 (psi by gauge) <br /> L. Length of Casing pipe: so Feet <br /> M. Will.casing pipe/uncased carrier pipe be cathodically protected: NO <br /> N. Hydrostatic pressure carrier pipe will be tested with before using 500 (psi) <br /> O. Will casing pipe be vented? NO Size: <br /> P. Will casing pipe/uncased carrier pipe have a protective coating? N� Type: <br /> Q. Depth of top of casing or uncased carrier pipe below base of rail or top of ground 9-2 feet. <br /> (Minimum at closest point) <br /> R. Method of installing casing pipe/uncased carrier pipe Drv Bore & Jack <br /> d bore& 'ack, directional, tunnel, other—s eci ) <br /> Attach to this application (3 copies)showing north arrow and a location sketch with crossings measured from the <br /> nearest railroad mile post and a profile sketch of actual situations showing relationship of tracks, contour of ground, the <br /> buried pipe, etc. Distance from each facility (encroachment)to the centerline of nearest road, crossing, bridge or other <br /> Railroad structures, must be clearly indicated. Right of way lines of railroad and labeled Street or highway, if involved, <br /> should also be shown. <br />