*FORM MUST BE SIGNED AND RETURNED PRIOR TO SERVICE CONNECTION.
RIGHT OF WAY AGREEMENT
RECEIVED of Northwestern Rural Electric Cooperative Association, Inc., Cambridge Springs, PA, the sum
of one ($1.00) dollar, in consideration of which I/we hereby grant unto the said Company, its successors and
assigns, the right, privilege, and authority to construct, reconstruct, operate and maintain poles, anchors,
brace poles, crossarms, cables and wires on, over, under, along and across my/our land and the highways
adjacent thereto, situated in the Township of
, County of
, bearing tax assessment
number(s) __________;
and
bounded
on
the
north
by
X
____________________,
on
the
east
by X____________________,
on
the
south
by
X
____________________,
on
the west
by X____________________ together with the right, from time to time, to relocate and remove its facilities and
appliances as said Company may deem necessary, or any part thereof with the right to control brush, trim and
remove trees as necessary so as to clear all crossarms, cables and wires by at least fifteen (15) feet, to
establish a thirty (30) foot ROW, to attach the necessary guy wires and to permit others to use facilities
constructed hereunder, with the right to lease and/or convey any part or all the rights hereunder to a telephone
or television cable company; provided, however, that not more than one line of poles shall be erected and
maintained pursuant to this grant. Buried cable, pedestals, and markers shall be shown on Exhibit A, attached
hereto and made a part thereof. Grantee agrees to restore Grantor’s property, if disturbed by construction or
maintenance of such buried cable, pedestals, and markers to as good condition as found by Grantee and to pay
for actual damage, if any, to Grantor’s growing crops arising therefrom.
Any poles or facilities erected hereunder may, without further consideration, be relocated to conform to new
or re-established highway limits.
IN WITNESS WHEREOF, I/we have hereunto set my/our hand(s) and seal(s) this X
X
, 20
, at
.
Witness:
X
day of
X
.
(Member’s Signature)
X
.
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF
)
On this _______ day of _______________, 20____, before me,________________, a notary public,
personally appeared ______________________________________ known to me (or satisfactorily proven)
to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed
the same for the purposes therin contained.
_____________________________________________
Notary Public