APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

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CUI
BPA F 4300.03e
(04-2026)
Page 1 of 7

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

OMB # 1910-5205
Expiration Date:
XX/XX/XXXX

Privacy Act Statement:
Authority: 42 U.S.C. § 7101 and 16 U.S.C. § 832 et seq.
Purpose: BPA will use this information to assess whether proposed use of right-of-way will interfere with BPA’s land rights.
Routine Uses: A record from the system may be disclosed as a routine use to contractors in performance of their contracts. Other
routine uses for which this information may be disclosed are listed in Privacy Act System of Record Notice DOE-24 Land Records
System which is published in the Federal Register.
Disclosure: Voluntary; however, failure to provide complete information may result in delay or denial of your application.
Instructions:
Applicants are required to complete all of pages 1 and 2. If not submitting an attached map, plan or sketch, page 3 is also
required.
Payments must be made electronically. To make a payment go to: https://www.bpa.gov/goto/HowtoPay select “BPA online
payments” hyperlink. In the form please fill in all the required fields. Under Purpose of Payment select REALTY APPLICATION FEE.
Please make sure to select the appropriate box below before making your payment. You should receive a confirmation when
finished.
No Application Fee: for individual landowners requesting personal use of BPA Right-of-Way.
$250 Application Fee: for developments or subdivisions. Application fee is non-refundable.
$2,500 Application Fee: for longitudinal occupancies that require multiple miles of BPA Right-of-Way. Application fee is
non-refundable
Please email your completed Application to [email protected] or mail to Bonneville Power Administration, Realty Information,
c/o TERO, P.O. Box 3621, Portland, OR 97208.
For questions or further information, please call 1-800-836-6619 or visit www.bpa.gov/goto/LandsCommunity
Date:
Applicant Information:
Applicant Name

Phone Number

Street Address
Zip Code

Fax Number
City

State

Email Address

Owner Information (Complete only if the applicant is not the owner):
Owner Name

Phone Number

Street Address
Zip Code

Fax Number
City

State

Email Address

Controlled Distribution (portion completed by BPA upon receipt)
Access is restricted to those with a Lawful Government Purpose and must be protected and marked when printed or distributed.
Controlled by - Name/Agency/Org/Contact Info:
CUI Category: PRVCY

Date:

File Code: PA-1300; Retention: Destroy no sooner than 20 years after the records are closed.

CUI
BPA F 4300.03e
(04-2026)
Page 2 of 7

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

OMB # 1910-5205
Expiration Date:
XX/XX/XXXX

Legal Description of the Property
This information is on your title, insurance policy, courthouse deed, or your tax statement.
Note: Applicant must provide a county assessor’s map showing the owner’s boundary lines and the location of use.

Location of Property:
Quarter Section(s)

Section

Township

Range

County

State

Purpose for Which BPA Right-of-Way/Property is to Be Used
Check all boxes that apply and complete the information on the following page.
Include a map, plan or sketch if appropriate.
Note: For submission of digital plans please provide a PDF version. BPA will request larger plans, if needed.
Driveway/Roadway Width (please attach existing and proposed grading plans)
Width

Material

Electric Service Line
Voltage

Distance to nearest BPA structure:

Distance to nearest BPA structure:
Overhead

Underground

Conduit Material
Burial Depth

Pipelines

Type:

Gas

Sewer

Water

Diameter
Material
Buried Depth
Distance to nearest BPA structure
Customer Interconnection Request Number (for interconnection requests only)
Other Uses: please describe your intended use in detail. In order to ensure safe clearance, please describe any equipment
that will be used for applied use (including equipment intended to construct and maintain the use). Space is provided on page
3 for a drawing. If grading, please attach existing and proposed grading plans.
Applicant Name

Applicant Title

Applicant Signature
File Code: PA-1300; Retention: Destroy no sooner than 20 years after the records are closed.

CUI
BPA F 4300.03e
(04-2026)
Page 3 of 7

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

OMB # 1910-5205
Expiration Date:
XX/XX/XXXX

Right-of-Way: draw in space provided below the location of the proposed use (identify structures and show distances and angles
from BPA structures). Diamonds on the line represent BPA structures on the right-of-way. Copy the series of letters and numbers
from the lower half of each BPA structure (see example below) and enter in “BPA Structure Identification” fields. Indicate which
direction is “North” in relation to the right-of-way.
BIG E-CHEM 1-81-2
BPA Structure Identification

PS2 1-2-A
BPA Structure Identification

Identify structures and show distances and angles from BPA structures or attach a separate drawing showing the layout and
distances to BPA structures.

BPA Structure Identification

BPA Structure Identification

File Code: PA-1300; Retention: Destroy no sooner than 20 years after the records are closed.

CUI
BPA F 4300.03e
(04-2026)
Page 4 of 7

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

OMB # 1910-5205
Expiration Date:
XX/XX/XXXX

Applicant Name
Complete ONLY if overhead or underground foreign line crosses an overhead BPA line. If the foreign line crosses more than one
BPA line use additional sheets.
Plan View

Structure A: BPA Line

Structure Number

Structure B: BPA Line

Structure Number

Pole 1 Foreign Structure Number
Pole 2 Foreign Structure Number
d1 Distance from BPA Structure A to crossing
d2 Distance from BPA Structure B to crossing
d3 Distance from Foreign Pole 1 to crossing
d4 Distance from Foreign Pole 2 to crossing
Θ1 Crossing angle at Pole 1
Θ2 Crossing angle at Pole 2

File Code: PA-1300; Retention: Destroy no sooner than 20 years after the records are closed.

CUI
BPA F 4300.03e

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

OMB # 1910-5205

APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

Expiration Date:

(04-2026)

XX/XX/XXXX

Page 5 of 7
Applicant Name

Profile View
Pole 1 Elevation

Pole 2 Elevation

Ground Elevation at Pole 1

Ground Elevation at Crossing

Ground Elevation at Pole 2

Foreign conductor elevation at crossing
Phase A

B

C

at 0 degrees F.

Optional – if BPA conductor was surveyed, provide the following
Survey Date and Time
Ambient Temperature
BPA conductor elevation for each phase

Left

Center

Right

Check this box if the applicant intends to provide an electronic Computer-Aided Design (CAD) file of the proposed design.
KMZ or XYZ file types preferred.

File Code: PA-1300; Retention: Destroy no sooner than 20 years after the records are closed.

CUI
BPA F 4300.03e

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

OMB # 1910-5205

APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

Expiration Date:

(04-2026)

XX/XX/XXXX

Page 6 of 7
Applicant Name
This page is used for Foreign Distribution crossings. A design drawing is accepted in lieu of this information.

Elevation BPA Line
Poles

Length

Depth Set

Class Pole

Pole 1
Pole 2

Fixtures
Size of Crossarms
Make & Catalog Number of Insulators:

Conductors
Number

Size

Kind

Voltage

MWT

Loading

Comments:

Pole 1 Configurations

Pole 2 Configurations

File Code: PA-1300; Retention: Destroy no sooner than 20 years after the records are closed.

CUI
BPA F 4300.03e
(04-2026)

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

OMB # 1910-5205

APPLICATION FOR PROPOSED USE OF BPA RIGHT-OF-WAY

Expiration Date:
XX/XX/XXXX

Page 7 of 7
Paperwork Reduction Act Burden Disclosure Statement

This data is being collected to complete an application for proposed use of BPA right-of-way to assess whether it will interfere with
BPA’s land rights. The information you provide will be used by realty and finance personnel to make a determination regarding the
use BPA’s right-of-way as per your request. Public reporting burden for this collection of information is estimated to average 1
hour 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining that data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestion for
reducing this burden to Office of the Chief Information Officer, Enterprise Policy Development & Implementation Office, IM-22,
Paperwork Reduction Act Project (OMB Control Number: 1910-5205), U.S. Department of Energy, 1000 Independence Ave SW,
Washington D.C., 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (OMB
Control Number: 1910-5205), Washington, D.C. 20503.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty
for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that
collection of information displays a currently valid OMB control number.
The Paperwork Reduction Act (PRA) of 1995 requires each Federal agency to seek and obtain approval from the Office of
Management and Budget (OMB) before undertaking a collection of information directed to 10 or more persons of the general
public, including persons involved in or supporting the operations of Government-owned, contractor-operated facilities.
Submission of this information is voluntary.

File Code: PA-1300; Retention: Destroy no sooner than 20 years after the records are closed.