PROJECT PLAN TRANSMITTAL REV 1 DT1078 112005 (TRANS 220

FEDERAL EMERGENCY MANAGEMENT AGENCY PROJECT WORKSHEET OMB NO
DATE INDIANA DEPARTMENT OF TRANSPORTATION ATTN INDOT PROJECT MANAGER
LYNLEY SHIMAT LYS MIAP INTRO FINAL PROJECT HADASSAH FILM

PROJECT NAME NJDOT SCOPE STATEMENT TSM LIMITED SCOPE FINAL
[PROJECT NAME] PARTNERSHIP STORY AGENCY PROJECT CONTACT NAME LOCATION
UNDP PROJECT DOCUMENT GOVERNMENTS OF

PROJECT PLAN TRANSMITTAL Wisconsin Department of Transportation

PROJECT PLAN TRANSMITTAL REV 1

DT1078 11/2005 (Trans 220 WI Admin. Code) Wisconsin Department of Transportation

Pursuant to s.84.063 Wisconsin Statutes, the Wisconsin Department of Transportation is furnishing the number of sets specified below of the available plan showing all existing utility facilities known to the department where they will conflict with the improvement identified below.

^To

We Energies - Electric

Nicole Smullen

333 W. Everett Street - A299

Milwaukee, WI 53203

^From

Mr. Phil Bielefeld, PE

HNTB Corporation

141 NW Barstow Street

PO Box 798

Waukesha, WI 53187-0798

^{Improvement
Project ID}

2704-00-76

^County

Racine

^{Highway
Route Number or Name}

Wisconn Valley Way, V Mt Pleasant

^{Improvement
Limits}

CTH KR to STH 11

^{Number
of Plan Set(s)}

One (1)

^{Anticipated
Year of Improvement Construction}

2019

^{Project
Classification}

Reconstruction, Expansion

^{Work
Plan Due Date}

February 17, 2019

For the purposes of Trans 220.05(4), this improvement is classified as indicated above. Your work plan is required at the above address on or before the due date indicated.

^{Transportation
Region Name}

Southeast Region - Waukesha

Philip J. Bielefeld

12/19/18

^{Consultant
Name}

HNTB Corporation

(Region or Consultant Representative Signature)

(If Computer-filled, Brush Script Font)

Project Utility Coordinator

(Date)

(Title)

PROJECT PLAN ACKNOWLEDGEMENT

Return this form within 7 days of receipt to address shown above.

Receipt of the above transmittal is acknowledged.

^{Utility
Name}

^{Utility
Representative Name – Please Print}

(Utility Representative Signature)

(Date)

(Title)

CHOOSES A COLLEGE PROJECT RUBRIC (FILL IN
REVISION CONTROL INFORMATION PROJECTSHSISCVSUTILITIESARRAYARRAYDOCV
14 NOVEMBER 2005 PATRINA BUCHANAN PROJECT MANAGER INTERNATIONAL

Tags: (trans 220, (trans, transmittal, project, dt1078, 112005