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Illinois Department of Transportation <br /> TRAFFIC CONTROL AUTHORIZATION REQUEST Marked Route: Illinois Rt. 105 (FAP 714) <br /> FOR PERMITS Section: 48X-Z (W,RS) 128(W-1,RS-2) <br /> Permit No.: 5-27283 <br /> County: Macon <br /> LOCATION: Northwest corner of Illinois Rt. 105 and US 51 <br /> IN Decatur <br /> (City or Village) (Use other side for sketch, if necessary) <br /> *INCLUSIVE DATES OF WORK: WORK HOURS: <br /> WORK TYPE: ❑ Utility ❑ Private Access ❑ Commercial Access � Other <br /> DESCRIBE WORK: Fence Erection. <br /> *CONTRACTOR OR AGENCY DOING BUSINESS: 'i <br />` <br /> ADDRESS: <br /> ""RESPONSIBLE PERSONS: (Construction Foreman and Applicant) <br /> Name Phone: (Office) (Home) <br /> (No lanes closed on holidays. Night closure requires 24-hour telephone number) <br /> Name Phone: (Office) (Home) <br /> Name Phone: (Office) (Home) <br /> Name Phone: (Office) (Home) <br /> CONTROLS: (Describe specific controls to be used, including reference to appropriate Highway Standards or <br /> sections of manual, and set forth any special controls proposed.) <br /> MOST CURRENT ISSUE OF TRAFFIC CONTROL STANDARDS: 701601-02, 701606-02, 701801-02, 702001 <br /> * TO BE COMPLETED BY APPLICANT AND CONTRACTOR. THIS FORM MUST BE COMPLETED AND SUBMITTED TO THE <br /> DISTRICT 5 ENGINEER OF OPERATIONS FOR APPROVAL ONE(1)WEEK PRIOR TO THE START OF WORK. <br /> Comments: <br /> �`SUBMITTED BY: <br /> APPROVED BY: <br /> District 5 Engineer of Operations <br /> Distribution: <br /> Permit File <br /> Field Engineer <br /> Traffic Control Supervisor Form BT-725 <br />