PUBLIC UTILITIES
ENCROACHMENT APPLICATION AND PERMIT
DAWSON COUNTY ROAD DEPARTMENT
207 W. BELL
GLENDIVE, MONTANA
1. Applicants Printed Name: __________________________________________
Address: __________________________________________
City, State, Zip: __________________________________________
2. Nature of Permit: ____Open Cut
____Approach
____Bore Crossing
____Bore/Case Crossing
____Parallel Line
3. County Road Numbers: __________
4. Legal Location: Section(s)______ Township _______ North Range _______ East
(Use more sheets or back of page if necessary)
5. Must attach an aerial view map* of the legal location from Google Earth. Mark on
map key features and the approximate place where encroachment will be. Each
road will require its own map.
*Will not be approved without this map*
6.
If Approach, approximate Traffic Site distance:
(Must be at least 200 feet both ways)
________feet (North, East) circle one
________feet (South, West) circle one
7. Duration of time requested for encroachment is: _________________________________
(i.e. 6 months, 3 years, lifetime, etc..)
8. ______ (Permitees Initials) I have received, read, understood and and will adhere to all the
stipulations set forth in section 11 of the Dawson County Road Department Road Policy.
I also understand that each job requires its own encroachment permit.
PERMITEE
__________________________
Printed Name
__________________________
Signature
COUNTY OF DAWSON
Approve: ______ Deny: ______
BY: ______________________ Date: _________
County Commissioner
__________________________
Company/Title
__________________________
Date
Investigated by: ________________________
Road Supervisor
Date: ____________________
REASON FOR DENIAL: _____________________________________________________________
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11. ENCROACHING, TRENCHING, AND/OR BORING OF COUNTY ROADS AND
COUNTY RIGHT OF WAYS
a. The county recognizes that at times, its roads may need to be encroached upon.
In circumstances where an encroachment must take place, a Permitee must
obtain and properly fill out an Encroachment Application & Permit. Once the
completed Encroachment Application & Permit is received by the Dawson County
Road Department it will be inspected by the Road Supervisor and approved by
the County Commissioners. NO form of work may take place until the
Encroachment Application & Permit has been inspected and approved.
b. “Encroach” refers to any forms of trenching, boring, approaches, excavations or
any work conducted or utilities installed on county roads or in county right of
way. “Utilities” refers to all forms of cables, lines, piping, and any other forms or
reasons for encroaching on county roads and right of way. “Permitee” refers to
any person(s) or entities wishing to encroach upon county roads or right of way.
Public utility companies must use the Public Utility Encroachment Application
and Permit.
c. The following stipulations will be expected under all forms of Encroachment
Application and Permits:
 Any paved roads will not be cut or trenched. Only boring is permitted.
 In order to minimize disturbance, boring under the county roads and
right of ways will be required whenever possible as determined by the
Road Supervisor.
 Permitee MUST inform the Road Supervisor at least 24 hours in advance
before any work begins. Failure of informing the Road Supervisor may
result in the immediate halting of the work on the encroachment until
Road Supervisor ok’s the commencement of work.
 All work contemplated under the Encroachment Application & Permit
shall be done under the inspection and to the standards and satisfaction
of the Road Supervisor.
 A minimum depth of 48 inches must be used when laying any utilities
through, under or across a county road or with in the county right of way.
A depth of less than 48 inches may be allowed depending on the
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circumstances AND with the advanced knowledge and written approval
of the Road Supervisor.
 Installing any utilities in the road or on the shoulder of the road is strictly
prohibited unless written approval from the Road Supervisor is obtained.
 Any utilities installed in the county right of way that will run parallel to
the county road must be installed as close to outside edge of the county
right of way as possible and as determined by the Road Supervisor.
 Installing any utilities through a culvert or cattle guard is strictly
prohibited and NO exceptions will be allowed.
 Installing any utilities near any culverts or cattle guards will be approved
only if a certain distance from the culvert or cattle guard is maintained as
agreed upon by the Road Supervisor and the entity wishing to install lines
near a culvert or cattle guard.
 All encroachments made from, upon or in any of the county roads or right
of way for the purpose of constructing a sewer, water, or petroleum line
shall be backfilled with sand to a depth of six (6) inches below the line
and six (6) inches above the completed surface of the utility lines. The
sand backfill shall be tamped around the utility line to insure a minimal
amount of settling around the line. Gravel shall be used for backfilling for
the remainder of the encroachment.
 All forms of encroachments upon or in any of the county roads or right of
way shall be backfilled with gravel and shall be tamped every 12-18
inches of backfill to insure a minimal amount of settling. All encroaches
shall be backfilled so that the original ground surface level will be
maintained. The Permitee will restore the same surface that was on said
county road or right of way at the time the encroaching was commenced
and shall resurface it in a manner suitable to the Road Supervisor
 In accepting the Encroachment Application and Permit, Permitee agrees
that the county is free of all liability and responsibility of any damage or
injury done to any installations or structures caused by the county, or by
a contractor working for the county who is engaged in construction,
alterations, repair, maintenance or improvement of the county road or
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right of way and Permitee, at its sole expense, shall be entirely liable and
responsible.
 In accepting the Encroachment Application and Permit, Permitee agrees
they will be, at its sole expense, 100% liable and responsible for any and
all problems and maintenance issues that may arise due to the
encroachment on county roads and right of ways. In cases of trenching
into or boring under a county road, Permitee will maintain such liability
and responsibility for a minimum of 6 months and up to 12 months as
deemed necessary by the Road Supervisor. At the discretion of the Road
Supervisor, a Release of Liability form will be signed after 6-12 months
releasing Permitee of all liability and responsibilities of the condition of
the county road or right of way.
 Any and all maintenance due utilities will be at the sole expense of the
Permitee for the lifetime of the utilities.
 If it is determined that due to the improper and/or unapproved
installation of utilities within county roads or right of way, the owner of
the utilities assumes all liability and responsibility for any damages
caused to any equipment or any injuries, to include medical costs, caused
to any one, and the cost of repairs to the county road, right of way or
equipment as well as all the loss of wages to an injured county employee.
 The County reserves the right to bill Permitee for any work done by the
county to correct problems that are caused from their encroaching on
county roads or right of way. Billed work can include cost of operator’s
wages, parts and materials, cost of fuel and cost of equipment according
to the current FEMA Schedule of Equipment Rates. Payment must be
made in full within 30 days of date of invoice. Failure to pay will result in
late fees, and, if necessary, legal actions to collect the debt and/or will be
included on the county tax notice.
 All company’s or entities of utility lines, pipe lines, power lines, telephone
lines or cable lines that are placed within in the county roads and right of
way shall be constructed and the lines laid in a manner to allow adequate
grading, rebuilding, and maintenance of road beds and ditch grades. All
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lines shall be a minimum of four (4) feet below the ditch grade unless
otherwise approved by the Road Supervisor.
 No work shall be commenced until the Encroachment Application and
Permit has been approved and the appropriate fee, if applicable, is paid.
If any work commences or has commenced before the Encroachment
Application and Permit is approved, permit will be denied and may result
in the removal of such utilities that were wrongfully installed.
 If Dawson County changes its road, necessitating changes in structures or
installations installed on county roads or right of ways under the
Encroachment Application and Permit, Permitee, at its sole expense, shall
make necessary changes according to the Road Supervisor. If such
changes are needed, the county will send a notice of required changes
that are needed. Permitee will have 14 calendar days from the date of
notice to make the required changes. If changes are not made within the
14 days, the county has the right to make the necessary changes and bill
the landowner for the work which can include cost of operator’s wages,
parts and materials, cost of fuel and cost of equipment according to the
current FEMA Schedule of Equipment Rates. Payment must be made in
full within 30 days of date of invoice. Failure to pay will result in late fees,
and, if necessary, legal actions to collect the debt and/or will be included
on the county tax notice.
 If work done under an Encroachment Application and Permit interferes in
any way with the drainage of the county road or right of way, Permittee
shall, at its own expense, make such provisions as the Road Supervisor
may direct to take care of said drainage. A notice of required changes will
be sent by the county to the address shown on the application. Permitee
will have 14 calendar days from the date of notice to make the required
changes. If changes are not made within the 14 days, the county has the
right to make the necessary changes and bill the landowner for the work
which can include cost of operator’s wages, parts and materials, cost of
fuel and cost of equipment according to the current FEMA Schedule of
Equipment Rates. Payment must be made in full within 30 days of date of
invoice. Failure to pay will result in late fees, and, if necessary, legal
ATTACHMENT 5
actions to collect the debt and/or will be included on the county tax
notice.
 All forms of encroaching shall be properly barricaded or marked. All
barricades or makers shall be adequately lighted or adequately
reflectorized to be visible at night and must comply with Montana State
Law. Flag persons shall be on the job site where required by Montana
State Law or the Road Supervisor.
 If work shall interfere with traffic, traffic control programs shall be
approved by the Road Supervisor before commencement of work. The
approved program shall be considered as a minimum and shall, in no
way, relieve or discharge Permitee from any of the obligations assumed
by accepting the Encroachment Application & Permit.
 Upon completion of work, any and all rubbish, debris, mud, dirt, or large
rocks must be immediately removed and the county road and right of
way left in a neat and presentable condition satisfactory to the Road
Supervisor.
 If Permitee wishes to remove any utilities that were installed on county
roads or right of ways shall inform the Road Supervisor at least 24 hours
in advance of removal of utilities and restore the premises to a condition
as inspected and approved upon by the Road Supervisor. Permitee agrees
they will be, at its sole expense, 100% liable and responsible for any and
all problems and maintenance issues that may arise on county roads and
right of ways due to the removal of said utilities. Permitee will maintain
such liable and responsibility for a minimum of 6 months and up to 12
months as deemed necessary by the Road Supervisor. At the discretion of
the Road Supervisor, a Release of Liability form will be signed after 6-12
months releasing Permitee of all liability and responsibilities of the
condition of the county road or right of way.
 If the duration an Encroachment Application & Permit was designated as
“lifetime” and Permitee wishes to remove the utilities under the permit,
they must, in writing, inform the county of the desire and reasons for
removing the utilities.
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 The Encroachment Application & Permit shall not be reassigned unless
written notice of reassignment is received by the Dawson County Road
Department.
 The Encroachment Application & Permit can be revoked by the county at
any time for any reason. If revoked, the county will give the Permitee a
fifteen (15) days written notice of the revoked Encroachment Application
& Permit, sent to the address shown on the application.
 If the Permittee violates any conditions set forth in the Encroachment
Application & Permit, the county reserves the right to revoke the permit
without any notice.
 All applications will be kept on file at the Dawson County Road
Department. A copy of the Encroachment Application & Permit will be
available upon request.
ATTACHMENT 5