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ENCROACHMENT APPLICATION / TEMPORARY PERMIT

Application date: 21/01 / 2024 Application No: 2023_36

Part 1 - Applicant’s details

The applicant must be an authorized signatory of the company.

Applicant’s name
Contractor’s name Sa’ad Awad Bin Zafrah
Address Head Office: Riyadh – CR No. 1010220371-CC No. 167795– Phone:
0112362360, Fax 0112362258
NA: Alrabea district 8039 – Qala’ah St. – Branching off Thumamah Road - Zip
Code 13316 Additional Number 2895
Mobile No 050 888 4342
Tel No 0112362360
Fax No 0112362258

Part 2 - Encroachment details

Type of encroachment
☒ Asphalt
☐ Railway
Road ☒ Sand / Gravel
☐ Other, please specify:
☐ Gas
Flammable ☐ Oil
☐ Other, please specify:
Pipeline
☒ Water
Non-
☐ Sewer
Flammable
☐ Other, please specify:
☐ Electrical
Cables ☐ Communication
☐ Other
Please specify:
Other

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Nature of encroachment
☐ Parallel to NEOM pipeline / utilities
☒ Crossing NEOM pipelines / utilities ☐ Under ☒ Over

Location of encroachment (with Coordinates)

Road Access for Location LA-3 Entrance ( 27°54'55.05"N , 35°21'25.78"E ).
Road Access for Location LA-3 Exit (27°55'15.35"N , 35°20'43.35"E ).
Road Access for Location PCY-1 Entrance ( 27°55'22.53"N , 35°20'30.56"E ).
Road access for Location PCY-1 Exit ( 27°55'45.38"N , 35°19'49.90"E ).
Road access for Location EMS-1 Entrance ( 27°55'50.95"N , 35°19'41.07"E).
Road Access for Location EMS-1 Exit ( 27°56'2.53"N , 35°19'22.67"E ).
Road Access for Location EMR-1 Entrance ( 27°56'5.53"N , 35°19'18.20"E ).
Road Access for Location EMR-1 Exit ( 27°56'12.80"N , 35°19'7.93"E ).
Road Access for Location BP-3 Entrance ( 27°56'15.81"N , 35°19'3.87"E).
Road Access for Location BP-3 Exit ( 27°56'25.28"N , 35°18'53.41"E).
Road Access for Location LA-2 Entrance ( 27°57'55.06"N, 35°17'4.55"E)-(27°57'56.78"N ,35°17'5.98"E).
Road Access for Location LA-2 Exit( 27°57'58.31"N, 35°16'59.51"E)-( 27°58'0.13"N, 35°17'0.95"E).
Road Access for Location LA-1 ( 27°58'30.82"N, 35°15'57.75"E)-(27°58'32.76"N , 35°15'57.63"E).
Road Access for Location EMR-4 ( 27°37'7.12"N , 35°32'19.98"E).
Road access for Location BP-7 ( 27°36'58.70"N , 35°32'22.87"E).
Road Access for Location BP-5 Exit( 27°45'41.82"N, 35°27'8.73"E).
Road Access for Location BP-5 Entrance ( 27°45'34.26"N, 35°27'12.96"E).
Road Access for Location EMR-3 Exit ( 27°45'29.63"N , 35°27'15.25"E).
Road Access for Location EMS-3 Entrance ( 27°45'21.65"N, 27°45'21.65"N).

Proposed duration of encroachment

Start (22/01/2024): Finish (17/06/2024):

Description of work
Road Work Equipment crossing the Pipe line via a steel ramp.
Barricade around the Waterpipes with Jersey Barriers
Applying Sub-base & Base Layers.

-3Attached additional documents? ☒ YES ☐ NO

Method of encroachment

☒ Other, please specify: Attached File.

Described on The Attached Method Of Statement.

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NEOM Project Owner Guarantee

The owner shall guarantee that he shall not release the bank guarantee of this project to the
Contractor unless he gets clearance from NEOM Water, to ensure that the Contractor completes the
works as per the conditions laid by NEOM Water:

Contractor’s name
Project owner name:
Signature:
Date
Stamp
NEOM Project Owner Department Contractor Project Owner
Name: Name:

Date: Date:

Signature: Signature:

Position: Position:

NEOM Evaluation for Encroachment

☐ Agreed ☐ Not agreed ☐ Other

Permit Valid From Date: …………………………………………. To Date: ………………………………………………

NEOM Water Management NEOM Water Transmission
Name Name
Date Date

Signature Signature
Position Position

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