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Land Lease Application Form is used to apply for the use of land. This application is not to be construed as a commitment to lease property without the company's written consent. This file is flexible since neither the lease name nor the corporation name is determined, and you can fill in any lease name or any corporation name. You can cut down some contents as well as add some contents.

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LAND LEASE APPLICATION--UNION PACIFIC RAILROAD COMPANY
Lease in name of ____________________________________________________________________________________________
If a corporation, state of inc. __________________________________
If a partnership, type _________________________________________________________________________________________
or d.b.a. ___________________________________________________________________________________________________
Applicant mailing address _____________________________________________________________________________________
Applicant billing address (if different) ____________________________________________________________________________
Name of person to contact regarding this lease _____________________________________________________________________
Phone No. ____________________________ Fax No. __________________________ E-mail _____________________________
Desired effective date _________________________________________
Detailed description of intended use of leased premises ______________________________________________________________
__________________________________________________________________________________________________________
List all hazardous materials or petroleum products you will be handling on:
Leased Premises_____________________________________________________________________________________________
Adjacent Premises____________________________________________________________________________________________
Will hazardous or petroleum wastes be generated? Yes ________ No ________ If Yes,
Describe ___________________________________________________________________________________________________
Will improvements be constructed on leased premises? Yes ________ No ________ If Yes,
Describe ___________________________________________________________________________________________________
______________________________________________________________________ (Construction plans may need to be provided)
Will storage tanks be installed? Yes ________ No ________ If Yes,
Commodity stored _________________________________, size _____________________, above ______ or below ______ ground
Will trackage be required? Yes ________ No ________ If Yes, contact the Sr. Mgr.-Track at (402) 997-3583.
Note: Land lease does not include use of trackage.
Do you plan to sublease to another party? Yes ________ No ________ If Yes,
Duplicate above information for sublessee and forward with application.
Provide location (i.e., city, street, railroad milepost) and a print/sketch of the proposed leased premises with
dimensions. Also depict any planned improvements on the leased premises with dimensions from nearest track.
Other comments pertinent to lease ______________________________________________________________________________
__________________________________________________________________________________________________________
This application is not to be construed as a commitment to lease property without Railroad’s written consent.
Applicant’s signature _________________________________________________________________________________________
Title ___________________________________________________ Date ______________________________________________
Land Lease Application Form
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