Deviation Request #

Project Name

Date

Page 1 of 2

Route Designation

Project Limits

Interstate, NHS or Non NHS Status (Design Manual Chapter 325)

Design Speed, and Posted Speed (see the Design Manual Chapter 430 or 440 and State Route Log)

Terrain Classification (see the State Route Log)

Current Average Daily Traffic (ADT) or Design Hourly Volume (DHV)

Truck Percentage and/or DDHV

Operating Speed

Existing Conditions

Rural or Urban condition (see the State Route Log)

Highway Classification (see the State Route Log)

Design Class (Design Manual Chapter 430 or 440)

Include information on feature(s) being deviated if an existing condition

Project Overview

Purpose and Need (Safety or Improvement)

Project Description

Applicable Matrix, including line (Design Manual Chapter 325)

Design Class (Design Manual Chapter 430 or 440) at completion of the project

Environment Constraints

Accident Summary and Analysis (sometimes this is optional)

Three year period minimum

Relationship of accidents to proposed improvements

Design Criteria

Design Manual section(s) or figure(s) being deviated, include date(s)

Alternative #1- No Build – Include description of Alternative

Cost (may include cost/benefit discussion)

Impacts

Advantages

Disadvantages

Reasons for Rejection

Alternative #2- Build to Full Design Level – Include description of Alternative

Cost (may include cost/benefit discussion)

Impacts

Advantages

Disadvantages

Reasons for Rejection

Alternative #3- Proposed Design – Include description of Alternative

Cost (may include cost/benefit discussion)

Impacts

Advantages

Disadvantages

Justification

Alternative #4 - Optional(Sometimes there is more than one non full design option to look at) – Include description of Alternative

Cost (may include cost/benefit discussion)

Impacts

Advantages

Disadvantages

Reasons for Rejection

Mitigation

Recommendation

Attachments (these may vary)

Vicinity Map

Channelization Plan(s)

Cross sections

Calculations

Cost Estimates

Alternative comparison plans