45297_PIEDMONT NATURAL GAS_20060101

\-0
❑CAMA / ❑ DREDGE & FILL 4 297
GENERAL PERMIT
Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name
Address
City
Phone # ( )_
Authorized Agent
❑ Cw
Affected
AEC(s):
❑ OEA
❑ PWS:
ORW:
yes / no
State ZIP "
Fax #( )
❑ EW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV. not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: )
❑ See note on back regarding River Basin rules.
UU0
Agent or Applicant Printed Name Permit Officer's Signature
More hnad city
�,�ftA z,
Signature "Please read compliance statement on back of permit is LAKIDate Expiration Date
ApplicationFee(s) Check# Local PlanningJurisdiction / Rover File Name

-AW
Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules _� Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

VICI'N!ITY MAP
NOT TO SCRtf_
«,* t SITE
M WAY ENCROACHU M REOUMM
LM04D:
IXt3T3N0 OAS INN
PRopmo OAS mmm
to
= P
U
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W
m
386
OAKS RD. -_ _ _ _ NATIONAL AVE.
SR. 1403 SR. 1403
5 -- 17� - -- - 22 --
10'
PROPOSED 4' PE., 2406,
SDR-11.0 GAS MAIN /
�A,
G�J
PROPOSED 4" PE., 2406,
SDR-11.0 GAS MAIN
NOTE:
4"PE GAS MAIN WILL
BE INSTALLED ON
D.O.T. 60' R/W.
PROFILE
I�200'--i-I
t8, t10' UNDER S
CREEK BED
JACK SMITH CREEK

mont
IIIII Natural Gas
Mrs. Terre
NCDENR
Division of Coastal Management
400 Commerce Ave.
Morehead City, NC 28557
Dear Engineer:
91MAY��ad�D
Morehead City DCM
P
;cr1um�
a
MAY a-2o,s
Morehead City pCM
Below I have listed the Piedmont Natural Gas intermediate pressure distribution main.
I have also included the length, size and type of pipe for the entire gas main crossing on
Jack Smith Creek on the N.C. D.O.T. Highway Right -of —Way.
Gas Main
NC. S.R. 1403 (Oak Road) ------- 200 LF of 4 inch PE 2406 SDR 11.5 gas main.
If you have any questions or need additional information, please do not hesitate to call.
Thank you,
Dan Rouse
Piedmont Natural Gas
New Bern Operation
111 Corporate Lane
New Bern, NC 28562
Phone: [phone] Ext. 2521
E-mail: [e-mail]
111 Corporate Lane • New Bern, NC 28562 • Phone [phone] • Fax [phone] • www.piedmontng.com

PIEDMONT NATURAL GAS COMPANY, INC.
PROPOSED CONSTRUCTION SKETCH
Approved Project No.
Division
Prepared By
Project: Oaks Rd.
INSTALL 2712' of 4" PLM MAIN
Design Dept. Comments
Estimate No.
Scale: 1 ":360'
Page of
DQte
General Main Ma
Per
��,. ? J
Initials
Construction Dept. Comments Initials

Now
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Piedmont Natural Gas
111 Corporate Ln. c�
New Bern, NC 28562
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PAUL W. CRAYT
108 DOGWOOD L I E
NEW BERN, NC 28-62
A.
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X ❑ Addressee
13. ceived b (Printed_ foam C. Date f Deli
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If YES, enter delivery address below: ❑ No
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' 2. Article Number
(Transfer from service label) S 7005 1820 0003 0434 6139
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ;

APR-07-2006 FRI 12:41 PM NC DIV OF COASTAL MGMNT FAX NO. 4 P. 02
R_t?'1'�_ RN
,k1).1:4.C.) ;INI, 1Z.1PA1x11A N ,l,':iZ().l.'l;It',I Y 0W.M,-R i�c)'.I'11 1Ct1',l1,ON/titi ��I�'7.ft
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N,1mv. of ilvlMillwl applrill-for pi:rIII it:.,.Pt�S�-.�nu��
11,ddr(-;cs (if r operty'. C !..c2.A-zo -4.
r (lotcr sl:;ct Y,;l,cr[orroad)
(Ciry e. County)
1' k�crcl)y <: rlii'y that I ovvit propoLty a(ljacelit to the above referenced property. "rho,
ivi�.l�.tal .,(�la]yirt; for this l.�ei`rllit hti-s described to my (as. shown on t-he attached
ilr2win;�,) III(' do-w-lopmr-lit tliry are proposing . A description or drawing, with
Eliitu:n;;ions, slt�aui(11>E'-pt�E)vi(kxl witti this letter.
I ii lve uo obj(.clions to this proposal.
I y�t,rt hrii cs objec.tior2s to >i�lcrrf i,� Mein proposed, ��lea write the Division of Coastal
i6 la it ag ri?ii-nt, 400 Cont raerre Ave., Morehead City, NC 28557 or call [phone]
►,uill►itr 10 (lays of r•er..eipt of tlii.s 120(ice. No req)onse is considered the same as no
01; ertir.,f, [,"yov. have? hretc notijlerl by Certified Mail.
WAIVER Si;(,UON
I un(Jorstr' l d flint it pit r,, (lock, illoadn" pilings, bzE-ikwater, boltliouse, lift or sandbags
insist bi, s,`t 13iack a minimum distanCe of 15' from my area of riparian access unless
waived by wv.,, (U you wish to wive the setback, you n-i st, initial the 7ppropriate blank
below.)
"t"� I ► WisJz to waive tht, 15' setback requirement.
1 d„ not wislj to waive; floc 15' setback requirement.
{'e eohr.n: Wfh ,\ri'.z code --

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Natural Gas2111111111
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Paul W. Crayton, Jr.
N 2111 Oaks Road
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STATE OF NORTH CAROLINA
DEPART ENT OF TRANSPORTATION
NUCHAEL F. EASLEY DIVISION OF HIGHWAYS
GOVERNOR
February 20, 2006
Shirley Byrd, Distribution Supervisor
Piedmont Natural Gas
I I I Corporate Lane
New Bern, NC 28562
SUBJECT: Encroachment Contract — Craven County (25-06-16)
LYNDO TIPPETT
SECRETARY
LrS---",g ED
Morehead City DCM
Attached hereto, for your files, is a copy of the Right of Way Encroachment Contract, which has
been properly executed. The contract covers the following:
4" natural gas main along SR 1403
APPROVED SUBJECT TO SPECIAL PROVISIONS:
Specific Requirements:
1) Crossing by bore only no open cuts will be permitted.
2) All roadway crossings that exceed 6" shall be encased.
3) All roadway crossings by dry bore method shall be a minimum of 3 feet below the elevation
of the existing roadway and 2 feet below the existing ditch, which ever is the deepest.
4) Pipe encasements shall extend from ditch line to ditch line in cut sections, and 5 (five) feet
beyond toe of slope in fill sections, and 3 (three) feet behind curb sections.
5) Directional boring using jetting with a Bentonite (or equivalent material) slurry is approved
at a minimum depth of 10 (ten) feet below the roadway surface (15 feet for controlled access
roadways) and 5 (five) feet below any ditch line. Any changes shall be submitted to the
District Engineer for approval prior to construction.
6) All utilities shall be placed in accordance with the manual on Policies and Procedures for
Accommodating Utilities on the Highway Rights of Way.
7) All concrete and asphalt driveways within NCDOT right of way shall be crossed by dry bore
methods. Proper Traffic Control; Devices, Signs, etc., Shall be Installed to Insure Public
Safety..
DIVISION TWO • P.O. Box 1587 • GREENVILLE, N.C. 27835
t PHONE [phone] • FAX [phone]
.� n

Page 2 of 4
Craven County
Eric 425-06-16
8) All shoulder installation shall remain a minimum of 1 foot distance peLl foot
slope) from the edge of pavement to the nearest inside wall of ex
t1
pMAY 2 5 7.00ti
General Requirements:
MRI!�'gad Ccty LIGM
1) The encroaching party shall notify the District Engineer's offic 46-3689] prior to
beginning construction and upon completion of construction.
2) The encroaching party is required to contact the appropriate Utility Companies involved and
make satisfactory arrangements to adjust the utilities in conflict with the proposed work prior
to beginning construction.
3) Trenching, bore pits and/or other excavations shall not be left open or unsafe overnight. The
Contractor shall comply with all OSHA requirements and provide a competent person on site
to supervise excavation at all times.
4) All fill areas/backfill shall be compacted to 95% density in accordance with AASHTO T99
as modified by the NCDOT. All material to a depth of 8 inches below the finished surface of
the subgrade shall be compacted to a density equal to 100% of that obtained by compacting a
sample of the material in accordance with AASHTO T99 as modified by the Department.
The Contractor shall dry or add moisture to the subgrade when required to provide a
uniformly compacted and acceptable subgrade. All material placed in a maximum of 6" lifts.
5) All earth areas disturbed shall be graded, dressed, seeded, mulched, and tacked with liquid
asphalt or other approved means within 10 days of completion of work in any area.
6) All workmanship and materials shall conform to North Carolina Department of
Transportation Standards and Specifications manual.
7) The encroaching party shall comply with all applicable federal, state and local environmental
regulations, and shall obtain all necessary federal, state and local environmental permits,
including but not limited to, those related to sediment control, storm water, wetland, streams,
endangered species and historical sites.
8) All existing structures, drainage or otherwise, located inside the Right of Way that are
affected by this work shall be restored to meet the NCDOT Standards and Specifications as
directed by the District Engineer.
9) Any pavement or drainage structure disturbed or damaged shall be restored to original or
better condition as directed by the District Engineer.

1
Page 3 of 4
Craven County
Enc #25-06-16
10) Traffic Control Devices shall be in accordance with the manual on Uniform Traffic Control
Devices and amendments or supplements thereto. Proper traffic control devices, signs, etc.,
shall be installed to insure public safety.
II)During non -working hours, equipment shall be parked as close to right of way lines as
possible and be properly barricaded in order to not have any equipment obstruction within
the Clear Recovery Area:
12) All roadway signs that are removed due to construction shall be reinstalled as soon as
possible, but at least by the end of the same workday.
13) Excavation material shall not be placed on pavement. Drainage structures shall not be
blocked with excavation materials.
14) All soils located inside the Right of Way shall be considered a type "C" soil. All trenching,
shoring and excavation shall follow the OSHA guidelines for this type of soil.
15) All splice boxes, manholes, and other appurtenances within the NCDOT right of way shall be
located at/outside the right of way line. Manholes and/or vaults shall not be placed in the
ditch line, side slopes of the ditches, or in the pavement.
16) All manholes and/or vaults within NCDOT right of way shall be of pre —approved design. If
any proposed structure is not of a design pre -approved by NCDOT, the encroaching party
shall submit details and design calculations signed and sealed by a State of North Carolina
registered Professional Engineer for approval prior to construction. NCDOT Design Services
may be contacted for an approved design list.
17) Manhole rings and covers, valve covers, and storm drain grates and frames shall be of the
traffic bearing types approved by NCDOT for use within the highway right of way.
18) Where utility is installed in the Right of Way and are not of ferrous material, a locating tape
shall be installed with the pipeline.
19) Any drop off greater than 2" from the edge of pavement shall be made safe by using a 6.1
slope or flatter or a width of 6 feet
20)An executed copy of this encroachment agreement, contract, and plans shall be present at
the construction site at all times during construction. If safety or traffic conditions warrant
such action, NCDOT reserves the right to further limi4 restrict, or suspend operations
within the right of way.
WMAYM,, 200.E
MIKehead City, DQMM

Sincerely,
C.E. Lassiter, Jr., P.E.
Division Engineer
CEL/gre
Cc: Mr. J.B. Williamson, Jr., Manager of Right of Way
Mr. C. E. Lassiter, Jr., PE, Division Engineer
Mr. Aaron C. Everett, District Engineer
Mr. Ken Mason, County Maintenance Engineer
Page 4 of 4
Craven County
Enc 425-06-16
Morehead City DCM

r
III' Piedmont
Natural Gas
January 26, 2006
Mr. A. C. Everette, District Engineer
NC Department of Transportation
201 S. Glenburnie Road
New Bern, North Carolina 28560
Dear Engineer:
We are enclosing 5 signed copies of the Right of Way Encroachment Agreement (Form R/W
16.1, Rev. 7-1-77), along with 5 copies of a print showing the Piedmont Natural Gas distribution
system in New Bern, Craven County.
This proposed extension will be a 4"-inch plastic intermediate pressure natural gas
distribution main to commence from our existing facilities at a point 713'feet east of the intersection of
S.R.1403 Oaks Road and S.R.1215 Simmons St; thence running as per attached drawing.
HED 5925
This proposed extension will be installed in accordance with the provisions of the Policies
and Procedures Manual for Accommodating Utilities on Highway Rights of Way and the Manual on
Uniform Traffic Control Devices for Streets and Highways.
All erosion control and sediment devices will be used on this encroachment. Less than one
acre of land will be disturbed and no erosion control plan has been submitted.
In accordance with the procedure, we will notify you when construction on this project has
been completed.
Sincerely,
2 5 2006
Shirley Byrd
Distribution Supervisor Morehead City DCM
111 Corporate Lane • New Bern, NC 28562 • Phone [phone] • Fax [phone] • www.piedmontng.com

r
IIIII'Piedmont
Natural Gas
January 25, 2006
Mr. A. C. Everett, District Engineer
NC Department of Transportation
201 S. Glenburnie Road
New Bern, North Carolina 28560
Dear Engineer:
Below I have listed the Piedmont Natural Gas intermediate pressure distribution main.
I have also included the length, size and type of pipe for all gas main along
NC DOTS highways in the event that you would need this information.
GAS MAIN
S.R. 1403 ---- 2712 LF of 4" Plastic, 2406, SDR 11.5 PLEXCO yellow pipe.
If you have any questions or need additional information, please
do not hesitate to call.
Thank you,
Sincerely,
Dan Rouse
Piedmont Natural Gas
New Bern Operations
111 Corporate Lane
New Bern, NC 28562
Phone: [phone] Ext.2521
E-mail: William.rouseRpledmontng
MAY 2 5 2006
Morehead City DCM
111 Corporate Lane • New Bern, NC 28562 • Phone [phone] • Fax [phone] • www.piedmontng.com

STATE OF NORTH CAROLINA
ROUTS SR. 1403 PROJECT HED-5925 COUNTY OF Craven
DEPARTMENT OF TRANSPORTATION
RIGHT OF WAY E , E E T
-AND- PRIMARY AN .1 H
Piedmont Natural Gas
111 Corporate Lane MAY 2 J 2006
New Bern, NC 28562
THIS AGREEMENT, made and entered into this the '?0 rig day of FEE3&AQy, 24®'b9DQee4�eaep&Jment
of Transportation, party of the first part; and Piedmont Natural Gas party of the second part,
WITNESSETH
THAT WHERAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route SR 1403, located 713 feet east of the intersection of S.R. 1403 Oaks Road and S.R. 1215 Simmons St. in New Bern,
Craven County with the construction of: a 4 inch -plastic intermediate pressure natural gas main for a distance of 2712 feet.
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of
the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment with in the limits of the
right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are
made a part hereof upon the following conditions, to wit:
That the installation, operation, and maintenance of the above described facility will be accomplished in accordance with the party of
the first part's latest POLICIES AND PROCEDURES FOR ACCOMMODATING UTILITIES ON HIGHWAY RIGHTS -OF -WAY, and such
revisions and amendments thereto as may be in effect at the date of this agreement. Information as to these policies and procedures
may be obtained from the Division Engineer or State Utility Agent of the party of the first part.
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and
proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance
thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures
necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the party of the first part
shall require the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his
successors and assigns, to promptly remove or alter the said facilities, in order to conform to the said requirement, without any cost to the
party of the first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights,
flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control Devices
for Streets and Highways and Amendments or Supplements thereto. Information as to the above rules and regulations may be obtained
from the Division Engineer of the party of the first part.
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and
claims for damage that may arise by reason of the installation and maintenance of this encroachment.
That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of the
Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution during
construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water
impoundments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and regulations
of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances
and regulations of various counties, municipalities and other official agencies relating to pollution prevention and control. When any
installation or maintenance operation disturbs the round surface and existing ground cover, the party of the second part agrees to remove
and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary by the
Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the construction site, at all times during construction, a copy of this
agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless
evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of the second part
agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed.
Unless specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will
not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part reserves
the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to the party of the
first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein is not
begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the party of the
second part from the party of the first part.
During the performance of this contract, the second party, for iiseif, its assignees e ccesscr _ :n i,+.=�P�t (hereinafter referred to as
the "contractor"), agrees as follows:
a. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in Federally -
assisted programs of the U. S. Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be
amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and
made a part of this contract.
b. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not discriminate on the
grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials
and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by
Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B
of the Regulations.
c. Solicitations for Subcontracts including Procurements of Materials and Equipment: In all solicitations either by competitive
bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurements of
materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the
contractor's obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race, color,
FORM R/W 16.1 (Rev. July 1, 1977)

or national origin. ''
Information and Reports: The contractor shall provide; all information and reports required by the Regulations, or directives
issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its
facilities as may be determined by the Department of Transportation or the Federal Highway Administration to be pertinent to
ascertain compliance with such Regulations or directives. Where any information required of a contractor is in the exclusive
possession of another who fails or refuses to furnish this information, the contractor shall so certify to the Department of
Transportation, or the Federal Highway Administration as appropriate, and shall set forth what efforts it has made to obtain
the information.
e. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this
contract, the Department of Transportation shall impose such contract sanctions as it or the Federal Highway Administration
may determine to be appropriate, including, but not limited to,
(1) withholding of payments to the contractor under the contract until the contractor complies, and/or
(2) cancellation, termination or suspension of the contract, in whole or in part.
d. Incorporation of Provisions: The contractor shall include the provisions of paragraphs "a" through "f' in every subcontract,
including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued
pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Department
of Transportation or the Federal Highway Administration may direct as a means of enforcing such provisions including
sanctions for noncompliance: Provided, however, that, in the event a contractor becomes involved in, or is threatened with,
litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Department of
Transportation to enter into such litigation to protect the interests of the State, and, in addition, the contractor may request
the United States to enter into such litigation to protect the interests of the United States.
R/W (161) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
R/W (161) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above written.
DEPARTMENT OF RANSPPO_RTATION
BY: 49 .r J ' S
DIVISION ENGINEER
ATTESTOR WITNESS: �
�L�'°`� Piedmont Natural Gas
Dan Rouse
Drafter
INSTRUCTIONS
Shirley Byrd Distribution Supervisor
Second Party
When the applicant is a corporation or a municipality, this agreement must have the corporate seal and be attested by the corporation
secretary or by the empowered city official, unless a waiver of corporate seal and attestation by the secretary or by the empowered City
official is on file in the Raleigh office of the Manager of Right of Way. In the space provided in this agreement for execution, the name of
the corporation or municipality shall be typed above the name, and title of all persons signing the agreement should be typed directly
below their signature.
When the applicant is not a corporation, then his signature must be witnessed by one person. The address should be included in this
agreement and the names of all persons signing the agreement should be typed directly below their signature.
This agreement must be accompanied, in the form of an attachment, by plans or drawings showing the following applicable information:
1. All roadways and ramps.
2. Right of way lines and where applicable, the control of access lines.
3, Location of the existing and/or proposed encroachment.
4, Length, size and type of encroachment.
5. Method of installation.
6. Dimensions showing the distance from the encroachment to edge of pavement, shoulders, etc.
7. Location by highway survey station number. If station number cannot be obtained, location should be shown by
distance from some identifiable point, such as a bridge, road, intersection, etc. (To assist in preparation of the
encroachment plan, the Department's roadway plans rnay be seen at the various Highway Division Offices, or at the
Raleigh office.)
8. Drainage structures or bridges if affected by encroachment (show vertical and horizontal dimensions from
encroachment to nearest part of structure).
9. Method of attachment to drainage structures or bridges.
10. Manhole design.
11. On u nderground utilities, the depth of bury under all traveled lanes, shoulders, ditches, sidewalks, etc.
12. Le # �. ize and type of encasement where required.
13' v ` erground crossings, notation as to method of crossing - boring and jacking, open cut, etc.
Location of vents.
GENERAL REQUIREMENTS
1. Any attachment to a bridge or other drainage structure must be approved by the Head of Structure Design in Raleigh
prior to submission of encroachment agreement to the Division Engineer.
2. All crossings should be as near as possible normal to the centerline of the highway.
3. Minimum vertical clearances of overhead wires and cables above all roadways must conform to clearances set out in
the National Electric Safety Code.
4. Encasements shall extend from ditch line to ditch line in cut sections and 5' beyond toe of slopes in fill sections.
5. All vents should be extended to the right of way line or as otherwise required by the Department.
6. All pipe encasements as to material and strength shall meet the standards and specifications of the Department.
7. Any special provisions or specifications as to the performance of the work or the method of construction that may be
required by the Department must be shown on a separate sheet attached to encroachment agreement provided that
such information cannot be shown on plans or drawings.
S. The Department's Division Engineer should be given notice by the applicant prior to actual starting of installation
included in this agreement.

PIEDMONT NATURAL GAS, C'OMPANY-'*-".,'A'�'=I�,Z7,,
OF AMER/AP,P =T, I =4 ' =Al d
P. O. Box 33068 �J=
=I 1023548
NationsBankofTexa N.A. '­_
.
Charlote,NC 28233-3068
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=
CHARLOTTE, NC28233
32 f1l11*0
Date
0511 OM06 Pay Amaltifif $100.0(i*
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Pay "ONE HUNDRED AND XXIIOO DOLLAR****
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To The NCDENR
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Order Of DI VISION OF COASTAL MANAGEMENT
400 COMMERCE RD s Z. I I
F Z Z" I Authorized Signature
MOREHEAD CITY, NC 28557
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t 11 VOID AFFER Q IX MONTH 1
1" 10 23548"I.':
I L 10000 121:
37500096 L?ii-
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Check Date: 05/10/2006 Vendor Number: 0000948311
Check No. 1023548
Invoice Number Invoice Date Voucher ID Gross Amount Discount Taken Late Charge Paid Amount
PROM261 648 05/01/2006 00791561 100.00
0.00 0.00 100.00
R S J�
y
e.P.
U (--D
Morehead City IDC�j,,
Check Number Date Total
Gross Amount
Total Total Total
Discounts Late Charges Paid Amount
1023548 05/10/2006 $100.00
$0.00 $0.00 S 100.00
QUESTIONS REGARDING THIS CHECK PLEASE CALL(704) 364-3120