Worksheet for Determination of Advance Acquisition for Complex Relocations

Worksheet for Determination of Advance Acquisition for Complex Relocations

North Carolina Department of Transportation

Worksheet for Determination of

Advance Acquisitionsfor Complex Relocations

This worksheet is to be completed by the appropriate NCDOT Right of Way representativeto identify properties which NCDOT may need to acquire in advance of project-wide right of way authorization because the property may involve complicated situations relating to: relocation of diverse or large numbers of displacees; complex improvements; graves; relocation of utilities; or other complex relocation matters.

These types of advance acquisitions are intended to minimize problems associated with meeting project delivery deadlines and avoid project delays which may arise due to time-consuming relocation issues common to the above situations. All questions in this worksheet should be answered and given in complete detail. If more space is required, additional pages may be attached.[1]

Section 1. Project Information

(To be completed by Right of Way Agent)

NCDOT Project TIP
WBS #
NCDOT Parcel No.
Division
County
Project Description
Current Project Right of Way Acquisition Start Date:
Current Contract Let Date:

Section 2. Property Information

(To be completed by Right of Way Agent)

Full Name Of Owner
Full Name Of Owner’s Representative
Address of Property
County PIN/PARID of Parcel
Residence Phone / Business Phone / Type of Property Use
Describe the types of buildings or improvements on the property?
[ ] None
[ ] Single-Family Residence
[ ] Multi-Family Residence
[ ] Mobile Home
[ ] Commercial Building
[ ] Miscellaneous Building
[ ] Graves
[ ] Utilities
[ ] Other
Describe in more detail here:
Describe the businesses located on property.
Describe the number and type of displaceeslocated on property.
Explain whether graves are on the parcel and if they are in conflict with the project.
Explain the nature of the utilities on the parcel that have to be relocated.

Section 3.Relocation Issues

(To be completed by Right of Way Agent)

State below the nature of the property and/or improvements and potential relocation issues. Check each applicable box and provide an explanation below.

1. The subject parcel involvesa complex property and/or improvements that will likely need to be relocated after acquisition of the land, and completion of the relocation process will likely take more than the typically allotted amount of time as compared to other relocations.

Explainbelow the complexity of the property and/or improvementsand relocation issues involved and why additional time is likely needed to complete the relocation process:

2. The subject parcel involves diverse and/or large numbers of displaceesthat will likely need to be relocated after acquisition of the land, and completion of the relocation process will likely take more than the typically allotted amount of time as compared to other relocations.

Explainbelow the diverse and/or large numbers of displacees and relocation issues involved and why additional time is likely needed to complete the relocation process:

3. The subject parcel involves gravesthat will likely need to be relocated after acquisition of the land, and completion of the relocation process will likely take more than the typically allotted amount of time as compared to other relocations.

Explain below the graves and relocation issues involved and why additional time is likely needed to complete the relocation process:

4. The subject parcel involves relocation of utilities that will likely need to be relocated after acquisition of the land, and completion of the relocation process will likely take more than the typically allotted amount of time as compared to other relocations.

Explain below the utilities and relocation issues involved and why additional time is likely needed to complete the relocation process:

5. The subject parcel involves other complex relocation issues that will likely require more than the typically allotted amount of time as compared to other relocations.

Explainbelow the complex relocation issues and property involved and why additional time is likely needed to complete the relocation process:

By:______
Signature of Division RW Agent, Area Negotiator, or Assistant State Negotiator / Date: ______
______
Print name and title:

Section 4.

(To be completed by Right of Way Management. Check all that apply)

Project right of way authorization has not been issued.

Confirm that the final environmental document has been approved, e.g., FEIS, and NEPA document issued, e.g., ROD. Attach email or confirmation.

Confirm with Roadway Design that Project plans are sufficiently complete to proceed.

Confirm that Right of Way, Utilities, and Roadway Design units agree that the subject parcel should be acquired in advance. Attach email or confirmation.

Confirm that the reasons for advance acquisition of the subject parcel are rational and justified.

By:______
Signature of Assistant State Negotiator, State Negotiator, or Assistant Manager of Right of Way / Date: ______
______
Print name and title

Section 5. Right of Way Manager

(To be completed by Right of Way Manager)

Advance acquisition is Approved / Denied/ Deferred (circle one) for the reasons stated herein. (Note: Right of Way approval is separate from other approvals, reviews or authorizations that may be required pursuant to NCDOT, state and federal rules, guidelines, and laws.)

By:______
Signature of Right of Way Manager, NCDOT / Date: ______
______
Print name and title
Notes:

FRM3-J

02-17-15

[1]The right of way agent should attach to this worksheet any plans, maps or photos that may help in the analysis of property.