APPLICATION To The Minister of the Ministry of Highways and Infrastructure
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1 Ministry of Highways and Infrastructure Regional Services APPLICATION To The Minister of the Ministry of Highways and Infrastructure (a) (b) Pursuant to: Section 14 of The Pipeline Act for consent for pipelines governed by the Pipeline Act which are within 30 metres of public highways other than provincial highways. Section 4 (1) (e) and Section 25 of The Highways and Transportation Act, 1997 respecting all pipelines within public highway right-of-way other than provincial highway right-of-way. Public highway means a road allowance or a road, street or lane, vested in Her Majesty or set aside for such purpose under the North-West Territories Act or an Act of Saskatchewan, and includes a bridge, culvert, drain or other public improvement erected upon or in connection with such public highway. Note: A different application form applies to pipelines, or any portion of a pipeline, within 90 metres of any provincial highway. Please use red or black pen APPLICANT: OWNER: Name: Name: Address: Address: City City Province Postal Code Province Postal Code Applicant Contact: Name Phone Fax Emergency Contact - Field Person Name File Pipeline Information Install Remove Commodity Province Postal Code Pipe Material Phone Fax/Cellular/Other Operating Pressure Is a Plan of Survey to be Filed/Registered? Yes No
2 PROPOSED P/L PROPOSED P/L 1. TYPICAL UNDEVELOPED ROAD ALLOWANCE 2. TYPICAL DEVELOPED ROAD ALLOWANCE (NOT TO SCALE) (NOT TO SCALE) Rural Municipality of No. Approved with the following restrictions: Date R.M. Official Signature Rural Municipality of No. Date R.M. Official Signature
3 APPLICATION FOR PIPELINES WITHIN THIRTY METRES (30 M) OF PUBLIC HIGHWAYS PLEASE READ THE NOTES AND INSTRUCTIONS ON THE LAST PAGE. Sketch the pipeline route location on the attached township grid. Drawings must be signed by each affected rural municipality. TOWNSHIP RANGE WEST OF MERIDIAN
4 PLEASE NOTE: 1. Pursuant to Section 16 of The Pipelines Act, consent of the Minister of the Ministry Highways and Infrastructure is required for oil or gas pipelines within thirty metres (30 m) of any public highway property limit or one hundred metres (90 m) of any provincial highway property limit. Water pipelines incidental to the drilling for or production or manufacture of oil or gas also require consent. Pursuant to Section 4 (1)(e) and Section 25 of The Highways and Transportation Act, 1997, the Minister may control and regulate the construction by any person across or along a public highway of irrigation ditches, drains, canals, telegraph, telephone or power transmission lines, pipelines, railways, driveways or other works or pertaining to the removal or replacement of any such works. Separate application must be made for each type of utility and category of highway. (ie. powerlines associated with a pipeline require separate consent; pipelines crossing both public and provincial highways require separate applications for each category of highway). 2. Permits are not transferable. Application for transfer of the permit must be made if the pipeline ownership changes. INSTRUCTIONS: 1. If the pipeline crosses a public highway which divides rural municipalities the drawing must be signed by both municipalities. 2. Public highways which do not follow original road allowances must be sketched onto the township grid. 3. If the pipeline does not cross but is within 30 m of the property limited of a public highway the distance from the property limit must be shown. 4. Three copies of the application drawing must be supplied with the application. 5. The name and number of the rural municipality must be shown on the drawing. The township, range and meridian must also be clearly marked on the drawing. 6. Typical crossing profiles must show pipeline depths. 7. For locations within the Central Region mail application to: Traffic Engineering and Development, Central Region 18, 3603 Millar Avenue Saskatoon, SK Canada S7P 0B2 Attention: Jennifer Fertuck, P. Eng. Director, Traffic Engineering and Development If further information is required, please phone (306) (Fax: ) Saskatchewan Highways and Infrastructure, Traffic Engineering and Development Section, 18, 3603 Millar Avenue, Saskatoon, SK Canada S7P 0B2
5 For locations outside the Central Region mail application to Saskatchewan Highway and Transportation s List of Regional Contact Persons as supplied below: CONTACT PERSONS Attention: Doug Kelly - Director, Traffic Engineering and Development Traffic Engineering and Development Section Southern Regional Office 1630 Park Regina, SK S4N 2G1 Phone: (306) Fax: (306) Attention: Doug Neis - Director, Traffic Engineering and Development Traffic Engineering and Development Section Northern Regional Office P O Box 3003, 800 Central Avenue Prince Albert, SK S6V 6G1 Phone: (306) Fax: (306)
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