Illinois Administrative Code
Title 92 - TRANSPORTATION
Part 1535 - CROSSINGS OF RAIL CARRIERS AND HIGHWAYS
Subpart H - BARRICADES
Appendix A - Forms
ILLUSTRATION C - Form 3
Current through Register Vol. 48, No. 38, September 20, 2024
Completion of this form is necessary to accomplish the statutory purpose as outlined in the Illinois Commercial Transportation Law, Section 18c-7401. Failure to provide the requested information may prevent your request from being processed.
Form 3
STATE OF ILLINOIS
ILLINOIS COMMERCE COMMISSION
Petition for permission to make a change in crossing
warning devices, or to install new warning devices,
under 92 Illinois Administrative Code 1535.400(d).
Date: December 15, 2005___
To the Illinois Commerce Commission:
The petitioner (Name of Railroad Company) shows:
(1) That it is a railroad company operating a line of railroad in the State of Illinois.
(2) That petitioner proposes and hereby makes application for authority to make a major change in crossing warning devices, or to install new warning devices, under 92 Illinois Administrative Code 1535.400(d) adopted by this Commission.
(3) That the location of the crossing, the nature of existing warning devices and proposed warning devices, and other pertinent facts in connection therewith, are set forth in the statement attached to and forming part of this petition.
(4) That petitioner's reasons and purpose, with reference to its said proposal are:
(State reasons and purpose)
_________________________________________________________________
(5) That the facts set forth in this petition and in the statement and plans or plats attached thereto are, all of them, true and correct to the best of petitioner's knowledge and belief.
WHEREFORE, the petitioner prays that the Commission will, if deemed desirable by the Commission, set the aforesaid matter for hearing, and that the Commission enter an order or adopt a resolution consenting to and granting authority for the making of the said proposed changes in or additions to crossing warning devices.
(Name of Railroad Company)
________________________________________
By ________________________________________
(Name of Person Submitting Form 3)
(Title of Person - use Enter key for additional lines)
(Phone Number)
__________________________
(Attorney for Petitioner)
__________________________
(Attorney's Address)
(Use Enter key for up to four additional lines.)
Statement, attached to and part of an application for permission to make a major change in crossing warning devices or to install new warning devices, under 92 Ill. Adm. Code 1535.400(d).
Name of Railroad
___________________________________________________________________
Track 1 N/E Bound________ mphS/W Bound ________ mph
Track 2 N/E Bound________ mphS/W Bound ________ mph
Track 3 N/E Bound________ mphS/W Bound ________ mph
___________________________________________________________________
ADDITIONAL INFORMATION
______________________________________________________________________
VERIFICATION
I, ______ (Name) ______, first being duly sworn upon oath depose and say that I am ______ (Title) _______ of ________ (Railroad Name) ___, an_____ (State) ______ corporation; that I have read the above and foregoing petition by me subscribed and know the contents thereof; that said contents are true in substance and in fact, except as to those matters stated upon information and belief, and as to those, I believe same to be true.
__________________________________________
(Signature above line & Title below line)