Applicant Field Contact Person

Utility Facility Description

Applicant Field Contact Person Field Contact Phone Number Applicant Reference (WO) Number Permit/Franchise No.

State Route Highway Scenic Class Access Control Begin MP End MP Reference MP Distance and Direction (From nearest reference MP)

Facility Description

Facility Detail

Lt/ Offset Distance Description R/W Remarks MP to MP Rt/ Width Including Pertinent Topography Info. (Turnouts, Xing From From Depth/ Road Approaches, Intersections, Cut, Fill, Culvert, Centerline Traveled Height D1 Items to be Installed / Constructed Left Right Guardrail, etc.) Xing Technique, Control Zone Objects, Way Enter-Leave R/W

Exhibit “B” Page ____ of ____ Pages

MS Word simulation of DOT Form 224-697 EF Current as of 7-1-99 Utility Facility Description - Continued

Applicant Field Contact Person Field Contact Phone Number Applicant Reference (WO) Number Permit/Franchise No.

Facility Detail

Lt/ Offset Distance Description R/W Remarks MP to MP Rt/ Width Including Pertinent Topography Info. (Turnouts, Xing From From Depth/ Road Approaches, Intersections, Cut, Fill, Culvert, Centerline Traveled Height D1 Items to be Installed / Constructed Left Right Guardrail, etc.) Xing Technique, Control Zone Obj., Way Enter-Leave R/W

Exhibit “B” Page ____ of ____ Pages