Instructions for Preparing a License/Permit Application

Block 1. Project Description. Describe the project and location. Give appropriate dimensions of structures, materials, elevations, depths, etc. 1a. Provide survey and abstract number; if the pipeline crosses more than one PHA ROW, please attach a continuation sheet with the necessary information marked Block 1 and 1a.

Block 2. Applicant’s Name. Enter the legal name of the party or parties to whom the License will be issued. If the responsible party is an agency, company, corporation or other organization, indicate the responsible officer and title. If more than one party is associated with the application, please attach a sheet with the necessary information marked Block 2.

Block 3. Address of Applicant. Please provide the full address, telephone number, and email address of the party or parties responsible for the application. If more space is needed, attach a continuation sheet marked Block 3.

Block 4. Authorized Agent’s Name and Title. Indicate name of individual or agency, designated by you, to represent you in this process. An agent can be an attorney, builder, contractor, engineer or any other person or organization. Note: An agent is not required.

Block 5. Agent’s Address and Telephone Number. Please provide the complete mailing address of the agent, along with the telephone number and email address where he/she can be reached during normal business hours.

Block 6. Emergency Contact. Licensee is required to provide PHA with an emergency contact person.

Block 7. Emergency Contact’s Address and Telephone Number. Please provide the complete mailing address of the person, the telephone number, and email address where he/she can be reached at any time.

Block 8. State Incorporated/Registered. Name of the state in which the Applicant is legally incorporated or registered. 8a. Provide the applicant’s legal form of incorporation.

Block 9. Dun & Bradstreet Number. Self explanatory.

Block 10. Name and Title of Corporate Officer signing the License. Self explanatory

Block 11. Name, Title, and Phone Number of Preparer. Name, title and phone number of person actually preparing the application.

Block 12. Signature. The application must be signed by the applicant or other authorized party (Agent).

Instructions for Pipeline, Cable, Transmission Line Data

Block 13. TXRRC T-4 Number. Provide the T-4 number from the Texas Railroad Commission permit to operate a pipeline. This information can be submitted with the As-built drawings. 13a. Expiration date of the permit.

Block 14. Project Location. Project location geo-referenced to x,y or latitude/longitude coordinates.

Block 15. Length. Length of the project (linear feet) within PHA ROW.

Block 16. Diameter. Diameter of pipe/cable in inches; transmission line in KV.

Block 17. County. County where the project is located.

Block 18. City. City where the project is located.

Block 19. Installation Method. Directional drilling, dry bore, etc.

Block 20. Product Type. Generic product type.

Block 21. Product Transported. Specific product being transported.

Block 22. Street Reference. Direction and distance to the nearest street.

Block 23. PHA Property Impacted. Type of PHA property ( HSC, other channel, bayou or body of water, railroad, road, land, etc.) impacted by the project. If the pipeline crosses more than one PHA ROW, please attach a continuation sheet with the necessary information marked Block 23.

Block 24. USACE Permit Number. Number assigned to the Section 404/10 permit processed by the USACE.

Block 25. PTRA/PHA ROW Width. ROW width in feet. If the pipeline crosses more than one PHA ROW, please attach a continuation sheet with the necessary information marked Block 25.

Block 26. Pipeline Orientation. Orientation of the pipeline to PTRA/PHA ROW, transverse or parallel.

Block 27. Valve Site. Yes or no. If more than one valve site, please attach a continuation sheet with the necessary information marked Block 27.

Block 28. Valve Site Size. If on PHA property, size of the valve site in square feet.

Block 29. Pipeline Name. Name given to the pipeline by the applicant.

Application should be submitted online if possible. Drawings and Certificate of Insurance should be submitted to:

The Port of Houston Authority
Channel Development Department
P.O. Box 2562
Houston, Texas 77252-2562

Payments (fees for applications, license, renewals, and as-built deposits) should be submitted with a copy of the first page of the application to (invoice to follow):

Port of Houston Authority
Attn: Lockbox Dept. – LB# 203417
601 Travis St.
Chase Bank Center, 14th Floor
Houston, Texas 77002

Last updated: 03/10/08

Port of Houston Authority
111 East Loop North • Houston, Texas 77029
P.O. Box 2562 • Houston, Texas 77252-2562
Phone: 713-670-2400

Copyright 2006 Port of Houston Authority • All Rights Reserved
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