045-1 Wyo. Code R. § 1-25

Current through April 27, 2019

Section 1-25 - Forms

(a) Information about the forms described in this rule and regulation shall be available through the Wyoming Department of Transportation Utilities and Railroads Section, 5300 Bishop Blvd., Cheyenne, Wyoming, 82009-3340, telephone307-777-4133.

(b) Please see the following pages for form examples.

WYDOT Petition

Form 10

(for Use by Other than Railroads)

STATE OF WYOMING

DEPARTMENT OF TRANSPORTATION

GRADE CROSSING PETITION

(File original and one copy)

To the Wyoming Department of Transportation

Utilities/Railroads Section

P.O. Box 1708

Cheyenne, Wyoming 82003

To open, close, improve or establish and install safety protection at any grade crossing within the petitioner's jurisdiction. The Petitioner herein respectfully shows:

1. Petitioner

2. Address

3. Proposal

located at _________________ , in the County of on the

Railroad at DOT Crossing No. _________________ at Railroad Mile Post # __________________

4. The reasons and purpose for petition:

________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ _______________________ (Describe in detail. Attach extra sheets and plans if necessary.)

5. Petitioner requests the Department to consider and act upon this matter, after investigation and hearing, if necessary, and proceed to enter an appropriate order.

6. Petitioner further asks that notice be given to Railroad, Respondent herein, upon whom service may be made at

dated at _________________ , Wyoming, this ____ day of ___________ 20___.

________________________________________

Petitioner(s) or duly authorized agent(s)

Attest / Witness:

_______________________________________

WYDOT Petition

Form 10A

Sheet 1 of 3

A. PURPOSE OF PETITION ( select from listed options )

B. APPLICANT

C. LOCATION OF RAILROAD/HIGHWAY CROSSING: Physical Features

D. EXISTING PROTECTIVE DEVICES

E. TRACK

F. OTHER FACILITIES NEAR CROSSING

G. PROPOSED WORK BY APPLICANT

(Provide a summary of the items to be installed, removed or altered. List the type of new construction, reconstruction, upgrading or modification being proposed. Use additional sheets if necessary.)

____________________________________________________________________________________

045-1 Wyo. Code R. § 1-25