Wyoming Administrative Code › Agency 045 - Transportation, Dept. of › Sub-Agency 0008 - Railroad and Transportation Tariffs Section › Chapter 1 - RAIL-HIGHWAY CROSSINGS › Section 1-25 - Forms

Current through July 13, 2024
(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.)
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