Kansas Department of Transportation

1. Is utility relocation necessary to clear proposed construction? Yes No
   
   
2. Utility is located on? Public Right of Way Private Right of Way Both Public and Private Right of Way
   
   
3. Will you be submitting a plan and estimate of relocation for reimbursement consideration?
   Yes No
   If yes, when? Format: "MM/DD/YYYY"
   
   
4. If a consulting engineering firm will be preparing relocation plan and estimate, enter name of firm.
   
   NOTE: Prior to a consulting engineer preparing relocation plan and estimate please forward a copy of proposed engineering agreement for review and approval by KDOT.
   
   
5. Will your firm contract the relocation work? Yes No
   
   
6. If yes, by? Not Applicable Bid Process Continuing Contract
   NOTE: If by continuing contract, provide copy of contract to this office at KDOT Bureau of Design - Coordinating Section, 13th Floor Harrison Center, 700 SW Harrison Street,Topeka, KS 66603-3754.
   
   
7. Estimate time interval from approval to proceed date to commencement of work date.
   days weeks months
   
   
8. Estimate number of working days needed to complete relocation.
   days
   
   
9. Company's Local Representative information:
   

   Name:
   Address 1:
   Address 2:
   City:
   State:
   Zip Code:
   Phone:

   
   
10. Comments:
    
    

* - required fields