20210330_Dominion_encroachment

Dominion Energy Virginia
10900 Nudrols Road, Sufte 400
Glen Allen, Virginia 23060
DominionEnergy.com
Reference #: TE021068001
j M Dominion
Energy
Consent Agreement for Right of Way Encroachment
VIRGINIA ELECTRIC AND POWER COMPANY ("Company") and FOSTER ALLEN
FORBES ("Requestor") enter into this Consent Agreement for Right of Way Encroachment
("Agreement") prepared by Company this 11th day of March, 2021.
Company is willing to grant to Requestor, this Agreement to encroach on, over and/or under
a part of Company's easement(s) ("Easement' or "Right of Way") identified as:
• Barco-Point Harbor Corridor, Parcel Number 118 [COR0025/118]
• Shawboro-Point Harbor Corridor, Parcel Number 170 [COR04121170]
• Line/Structure(s) #:2064/149-150, 20731149-150
The encroachment ("Encroachment") is described as:
• Five (5) foot tall sand berm around existing pond
• Two (2) foot tall sedimentation control berm
• Existing pond filled in and levelled
The Encroachment as described above is located as follows:
8180 Caratoke Highway, Powells Point, N.C.
Company, under its Easement(s) identified above, hereby grants Requestor permission to
install the Encroachment, described above, subject to the following terms and conditions
hereinafter set forth.
The minimum distance required by the Occupational Safety and Health Administration
("OSHA") shall be maintained between electrical conductors and any part of the
Encroachment or equipment used in the installation or maintenance of the Encroachment.
Sag of conductors varies with changes in operating and ambient temperatures; therefore,
required clearances will be based upon maximum sag. The minimum clearance shall be
governed by the clearance required for the 230kV line. For current voltage information
see Exhibit "A". Voltage and conductor arrangement is subject to change. It is Requestor's
responsibility to confirm voltage and location of conductors prior to installation,
maintenance or repair of the Encroachment.
2. Company access to its facilities shall not be hampered at any time by the installation, use,
maintenance or presence of the Encroachment. Company shall not be liable for damage
to the Encroachment resulting from exercise of its Easement rights.

03/11 /21
3. Permission for the Encroachment described in Exhibit "B" does not include permission for
storage on Company Easement of material or equipment related to the Encroachment.
4. No portion of any building, house, garage, porch, deck, shed, trailer, barn, playhouse,
above -ground or in -ground swimming pool, dumpster or any other type of structure,
temporary or permanent, shall be permitted on the Easement. This includes, but is not
limited to, any building projection or attachment such as roof overhang, gutters,
garage lighting or window appurtenances. Portions of buildings and other
structures found within Company's Easement(s) are required to be removed when
discovered.
5. Requestor shall restore any erosion or settling, within the Easement, related to the
installation or maintenance of the Encroachment. Requestor shall comply with all state
and local erosion and sedimentation control laws and shall not adversely affect grade
elevations and water drainage. patterns.
6. It is the Requestors responsibility to notify Company of any damage to Company facilities
by Requestor, its employees, contractors or agents. If any counterpoise (ground wire
buried eighteen (18) to twenty-four (24) inches deep) is damaged, cut or severed, notify
William Gatlin - Manager Field Transmission Lines, immediately so necessary repairs can
be made.
Mobile: [phone] E-Mail: [e-mail]
7. Requestor shall be responsible for all associated costs for the repairs of Company facilities
(including but not limited to structures, guys, anchors or counterpoise) damaged by
Requestor, his/her/theirrds employees, contractors or agents.
8. If the Encroachment is determined to be unsafe by the Company at a future date, the
unsafe condition shall be corrected or removed at Requestor's expense within forty-five
(45) days after written notification from the Company. If not so corrected or removed by
Requestor, the unsafe condition may be corrected or removed by the Company at
Requestor's expense without liability by the Company for any resulting damage.
9. This Agreement in no way reduces the Company's rights under the Easement(s) identified
above. The Company may at any time exercise its Easement rights in a way that conflicts
or interferes with the Encroachment described above. Upon notice from the Company,
the Requestor will promptly modify, rearrange or remove the Encroachment to enable the
Company to exercise its Easement rights without conflict or interference with the
Encroachment. Requestor will be responsible for the cost of any such modification,
rearrangement or removal. If Requestor fails to so modify, rearrange or remove the
Encroachment within forty-five (45) days after notice from the Company to do so, the
Company may modify, rearrange or remove the Encroachment without liability for damage
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03/11 /21
resulting therefrom, and Requestor shall promptly reimburse the Company for the cost of
such modification, rearrangement or removal.
10. Requestor shall begin physical installation of the Encroachment within one (1) year of the
date of execution of this Agreement. If installation does not begin within that period, this
Agreement shall become invalid. A new Encroachment application must be submitted
before further consideration and will be subject to a processing fee. For the avoidance of
doubt, Company's permission for this Encroachment in no way implies or assures that
Company will reissue an Agreement for this Encroachment in the future should this
Agreement become invalid.
11. Requestor shall give at least five (5) days advance notice, except in emergencies, of any
activities being performed within the Easement to Timothy Hindman, Sr. Right -of -Way
Management Representative so that the Company, at its discretion, may have an
inspector present while the work is in progress. Requestor pays the costs of the
inspector.
Mobile: [phone] E-Mail: [e-mail]
12. This Agreement provides Requestor only with approval to encroach on Company's electric
transmission Easement. For the avoidance of doubt, Company's approval of this
Encroachment in no way implies or assures that Company will grant Requestor's future
request (if any) that Company quitclaim or subordinate in favor of Requestor any portion
of Company's electric transmission Easement.
13. Requestor, its/their heirs, successors, assigns, contractors or subcontractors hereby
agree to indemnify and save harmless Company, its officers, agents and employees from
any and all claims, demands, damages, including death, and liability of every kind and
nature whatsoever for, on account of or growing out of the Agreement hereby granted,
except when such claims and demands are caused solely by the negligence or willful
misconduct of Company, its agents, employees, successors or assigns.
14. Before Requestor or its contractors, subcontractors and assigns enter upon Company's
Easement, each shall obtain or keep, in full force and effect, with respect to its/their work
within the Company's Easement, with insurance companies authorized to do business in
the Commonwealth of Virginia, the following insurance:
a) Workers compensation insurance as required by the statutory benefit laws of the
Commonwealth of Virginia or approved self-insurance and employer's liability insurance
with limits of at least $1,000,000.00 bodily injury by accident and $1,000,000.00 each
employee for bodily injury by disease.
b) Commercial general liability insurance with coverage limits of at least $2,000,000.00
each occurrence, $2,000,000.00 aggregate. Such insurance shall include, but not be
limited to, specific coverage for contractual liability encompassing the previously
referenced indemnity and liability requirements.
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c) Automobile liability insurance covering bodily injury and property damage with a total
limit of at least $2,000,000.00 per accident. Such insurance shall cover liability arising out
of any automobile (including owned, hired and non -owned automobiles).
The insurance required in paragraph (b) above shall: (1) name Company, its officers,
directors and employees as an additional insured; (2) be primary coverage with respect to
any liability coverage carried by the Company; and (3) provide for claims by one insured
against another such that, except for the limits of insurance, the insurance shall apply
separately to each insured against whom a claim is made or suit is brought.
Requestor and Requestor's contractors, subcontractors and assigns waive, and will
require their insurers to waive, all rights of recovery against Company for damages to the
extent these damages are covered by the insurance required to be maintained pursuant
to the insurance requirements.
Before Requestor, Requestor's contractors, subcontractors and assigns enter upon
Company Easement, and thereafter upon the renewal of their insurance policies,
Requestor, Requestor's contractors, subcontractors and assigns, shall provide certificates
of insurance to Company evidencing the coverage and limits required by this Agreement
and that Company, its officers, directors and employees are an additional insured.
Failure of Company to demand such certificates or other evidence of full compliance with
these insurance requirements or failure of Company to identify a deficiency from evidence
that is provided shall not be construed as a waiver of the obligation of Requestor,
Requestor's contractors, subcontractors and assigns to maintain such insurance.
Requestor, Requestor's contractors, subcontractors and assigns, or their respective
agents, representatives or insurers shall provide thirty (30) days prior written notice of
cancellation to Company, except for non-payment of premium to which ten (10) days'
notice shall apply.
15.Requestor shall notify MISS UTILITY (1-800-552-7001) in a timely manner in advance of
construction to allow existing nearby underground utility conflicts to be identified.
16. Requestor may remove topsoil and gravel from portions of the Easement not occupied by
Company facilities. In such cases Requestor must maintain a minimum island of
undisturbed material with a fifty (50) foot radius on all sides of said facilities. The slope
ratios, normally 3:1 or less, and transmission line access lanes must be maintained.
17. Should it be necessary to verify the final grade of the proposed cut and/or fill, then it will
be the responsibility of Requestor to reimburse Company for all actual costs. If the
verification reveals that the cut/fill/grading was not done as approved, then Requestor is
responsible for all costs involved with correcting the problem(s).
18.There shall be no grading, excavation, filling or other construction activities within fifty (50)
feet of any Company structure, foundation, guy, anchor or any other Company facilities.
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19. Clean fill material may be placed on right-of-way to within fifty (50) feet of any existing or
proposed transmission structure. In all cases, no fill will be allowed until the proposal is
reviewed by the Electric Transmission Right of Way Management to insure proper grade
and operating clearances.
20. Requestor is responsible for acquiring, from the owners of the underlying fee simple or
otherwise, any additional property rights necessary for the Encroachment location. For
the avoidance of doubt, Company does not convey, or otherwise transfer to Requestor
any Easement right that Company may hold nor does Company make any representation
or warranty as to the status or availability of any rights that may be required for Requestor
to make use of the Encroachment or Easement.
21. It is the responsibility of the Requestor to ensure that all contractors or sub -contractors
are aware, informed of and abide by these conditions.
22. The above conditions only apply as specific to and set forth in this Agreement and do not
set a precedent for further Agreements.
23. All notices, requests, demands and other communications required to be given, (except
as otherwise indicated) shall be deemed to have been duly given if in writing and mailed,
as follows:
If to Foster Allen Forbes
Requestor: 5104 Lunar Drive
Kitty Hawk, North Carolina 27949
If to Dominion Energy Virginia
Company: Highwoods One, Suite 400
10900 Nuckols Road
Glen Allen Virginia 23060
Attention: Electric Transmission Rights -of -Way
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This Agreement is granted only to Requestor. It is not an interest in real property; it does not
run with the underlying land or benefit any successors in interest to the underlying land, and
it may not be assigned or transferred to anyone else without the prior written approval of
Company, which Company may withhold in its sole discretion. If Requestor is not the owner
of the property on which the Encroachment is to be located; it is Requestor's responsibility to
obtain any and all necessary permission(s) or easement(s) from the property owner(s) for the
Encroachment prior to installation.]
For this Agreement to become effective, Company must be in possession of both the
executed Agreement and the required processing fee.
Requestor must return the executed Agreement and payment to Company by April 19, 2021
to:
Dominion Energy Virginia
10900 Nuckols Road, Suite 400
Glen Allen, Virginia 23060
Attention: Nancy Gustaysson
[phone] or [e-mail]
Additional contact: Dominion Energy Virginia at 1-800-215-8032 or e-mail at
ETROMdominionenergy.com.
[SIGNATURES TO FOLLOW]
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Company, Authorized Representative, will execute and finalize Agreement upon return of
Agreement executed by Requestor or its Authorized Representative. Requestor will be
provided a fully executed copy of Agreement for their records.
In consideration of this Agreement granted by Company for the above -described
Encroachment, Requestor hereby agree(s) to the terms and conditions stated in the foregoing
Agreement.
Company and Requestor hereby cause this Agreement to be executed by their duly
Authorized Representative.
VIRGINIA ELECTRIC AND POWER COMPANY
Mot
Fallon Madrid Date
Supervisor, Rights of Way Management
Electric Transmission
Authorized Representative
PROPERTY OWNER
By.
�� , (� h,
Foster Allen F
Owner
Page 7 of 7
Date

DOMINION ENERGY
TOWER 149 —
LINE 2064/2073
(86' FROM EXCAV EDGE)
25'W
UNEXCAV TT x 8'W BERM
BUFFER FOR SEDIMENTATION
CONTROLAROUND
EXCAVATION AREA,
REMOVED DURING
TCH RECLAMATION
SEDIMENT
PONDoO
INTAKE
EXCAVATION
6.23ACRES
AVG DEPTH - 30 FT
MAX DEPTH - 35 FT
STATE WETL
50'BUFF ..... .
<
.......... 0\
UNEXCAV
10 BUFFER ....... ri
..
EXISTING POND, 0.51 ACRES
rsv
A3A, TO BE USED AS SEDIMENT POND
wo-
OVER
FLOW SEDIMENT POND BERM
STALL x 32'WIDE
UNI
BU
STOCKPILES &
LOADING
4.43 AC
SEDIMENT POND BERM
5'TABOVE NGL, REMOVED
DURING RECLAMATION.
PUMP POND FILLED IN & LEVELLED
0
......................................
LOADING AREA
TE021068001
EXHIBIT "B'r

ominion
EnergyMW
Electric Transmission Encroachment
Invoice
Reference # TE021068001
To the Requestor:
In order for this letter of consent for the encroachment that Kenneth Elliott has
requested on behalf of Foster Allen Forbes to become effective, the requested
processing fee must be returned to Dominion Energy Virginia no later than April
19, 2021.
The total amount due is $ 19000.00
Checks should be made payable to Dominion Energy Virginia. Please include
the reference number listed above on your payment.
Mail your payment with this invoice to:
Dominion Energy Virginia
10900 Nuckols Road, Suite 400
Glen Allen, VA 23060
Attention: Nancy Gustaysson
Please contact Nancy Gustaysson at [phone] or
nancv.l.QustayssonO-dominionenergy.com if you have any questions.