3_-_Traffic_Control_Authorization_Request.pdf
PDF 27 KB Posted
- Attached to
- FY 2024 UTILITY MAINTENANCE
- Solicitation number
- 2023-26
- Issued by
- Mclean County, Illinois
About this file
The document is a Traffic Control Authorization Request form from the City of Bloomington, Illinois, designed to be completed by contractors or agencies planning to conduct work that requires traffic management. The form is a standardized template for requesting approval to implement traffic controls during maintenance, construction, or other types of work, with sections to specify the project location, work dates and hours, work type, contractor information, and detailed traffic control measures.
The form requires comprehensive contact information for the responsible party, including multiple contact numbers for scenarios involving work during evening hours, weekends, or holidays. It includes spaces for describing specific traffic control strategies, referencing appropriate highway standards or manual sections, and noting any special proposed controls. The form is intended to be distributed to the project file, City of Bloomington Police, and City of Bloomington Fire departments, with signature lines for submission by the contractor and approval by the City Engineer, ensuring proper coordination and safety protocols for traffic-impacting work activities.
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Text version
Traffic Control Authorization Request
PROJECT:
LOCATION: Marked Route _______________ Location ______________________
INCLUSIVE DAYS OF WORK: __________________ WORK HOURS:_____________
WORK TYPE: Maintenance Construction Traffic Other
Work Description _______________________________________________________
CONTRACTOR OR AGENCY DOING WORK: ________________________________
RESPONSIBLE CONTACT: (Construction Foreman, or Traffic Maintenance Person)
Name:_________________ Phone:_________ (Office) ________ (Mobile) (If traffic control is to be employed between 5:00p.m.and 8:30a.m.or on Saturday, Sunday or holidays, give three additional contacts.)
Name:__________________ Phone:__________ (Office) __________ (Mobile)
Name:__________________ Phone:__________ (Office) __________ (Mobile)
Name:__________________ Phone:__________ (Office) __________ (Home)
CONTROLS: (Describe specific controls to be used, including reference to appropriate
Highway Standards or section of Manual, and set forth any special controls proposed.)
COMMENTS: __________________________________________________________
Distribution: Submitted by_________________________ Project File City of Bloomington Police Approved by_________________________ City of Bloomington Fire City Engineer
File details come from the government source that posted it. Updated .