Utility Forms

Utility forms can be accessed and saved using the links in the table below.

Table 1-2: ROW and MNT Division Forms Relating to Utility Adjustment Work
Form Number	Title
1082	Utility Installation Request (To be used with Non-Reimbursable utility adjustments or any placement in which the utility does not own a property interest.)
ROW-Indemnity	Indemnity Agreement
ROW-N-17	Release of Easement
ROW-N-30	Quitclaim Deed
ROW-N-85	Subordination of Mineral Lease
ROW-N-88	Subordination of Mineral Lease – Controlled Access Highway Facility
ROW-N-PSTRA	Petroleum Storage Tank Removal Agreement
ROW-U-13	Reimbursable Authorization Letter
ROW-U-27	Support for Certificate of Partial Payment for Utility Accommodation
ROW-U-35	Standard Utility Agreement
ROW-U-40	Signature Authority
ROW-U-45	Tabulation of Utility Adjustments (SUP)
ROW-U-48	Statement Covering Utility Construction Contract Work (as Appearing in Estimate)
ROW-U-139	Indemnity Agreement for Fiber Optic Facility
ROW-U-Affidavit	Affidavit of Property Ownership (Utility Owner / Disinterested Party)
ROW-U-AGMNTCheck	Utility Accommodation / Adjustment Checklist
ROW-U-BillChkDist	Utility Payment/Billing Checklist
ROW-U-CFUA	Certification for Utility Accommodation
ROW-U-Clearance	Utility Clearance Letter
ROW-U-COA	Standard Utility Agreement - Supplemental Agreement No. __ to U-__
ROW-U-EWA	Emergency Work Authorization – Post Highway Letting
ROW-U-JUA	Utility Joint Use Agreement
ROW-U-MA	Master Utility Agreement
ROW-U-NOPC	Notice of Proposed Construction
ROW-U-NORA	Notice of Required Accommodation
ROW-U-SP2125	Application for State Participation in the Relocation of Certain Publicly-Owned Utility Facilities
ROW-U-UAD	Utility Accommodation Declaration

Section 1: Utility Adjustment Overview