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Director of Project Development Administrator of Highway Design memorandum  CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s AGREEMENT for _____________________ ________________________________________________________ FOR YOUR SIGNATURE: WRITTEN BY: ________________________________ DATE: ______________ CHECKED BY: ________________________________ DATE: ______________ PROOFREAD BY: ________________________________ DATE: ______________ APPROVED BY (Section Chief or Assistant): ________________________________ DATE: ______________ FINAL APPROVAL (Section Chief or Assistant Initials): __________ DATE: ______________ MAILED FOR EXECUTION BY: ________________________________ DATE: ______________ (Two Originals) UTILITY/MUNICIPALITY EXECUTION DATE: ______________ IF FEDERAL OVERSIGHT (NON-EXEMPT): Unexecuted MAILED FOR REVIEW BY: ___________________________ DATE: ______________ Executed MAILED FOR APPROVAL BY: ___________________________ DATE: ______________ (Two Copies to FHWA) FEDERAL APPROVAL DATE: ______________ DISTRIBUTION (AFTER UTILITY EXECUTION OR FEDERAL APPROVAL): DISTRIBUTED BY: _______________________________ DATE: ______________  CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s  ORIGINALS TO: (Utility Agreement File, Utility, Municipality) COPIES 2 Construction (1 each as noted)2(Office File & Contract Administrator)1 Coordinators Project File11 Finance & Contracts Mary Dubey11 Project Programming11 Highway Design File11 District __(Appropriate District When Involved)1 City/Town of ___________________(When Involved)1 Right-of-Way(When Involved)1 Turnpikes(When Involved)1 ______________________________(Other When Involved)1 Engineering Audit1For Tracking Purposes    DEbcdef  5679VWXZwżx jCJUjFnoR CJUVaJ jCJUjEnoR CJUVaJ jCJUCJCJCJ 5CJ\;CJ;CJ j`;CJUjDnoR CJUVaJj4;CJUjBnoR CJUVaJjAnoR CJUVaJj;CJU;CJ+Rhf   $ dPa$ P $ da$ $ a$ $ ^a$  P^ $ 4a$ $ a$ $ 8Pa$ $ 8 a$ P<   wxyz01tu,-Rtu   2 3 4     Y Z ȽѯȩԤ jCJU j UjInoR CJUVaJ jU 5CJ \>*CJ >*CJ W5CJ W\ 5CJ\CJ CJCJ 5CJ\CJCJEH jCJU j CJUjHnoR CJUVaJ501tutu    $$d &d N P a$  $a$< P<   2 3 4     } $ P<a$$$d &d N P a$ $ \ <a$  h < ,    h <$ P< $$ P<a$$$d &d N P a$  Y Z $ - 8 Y Z \ $ P$Ifa$ $ P$Ifa$$ hP$Ifa$ h,P h   $a$$ Pa$ # $ & - 7 8    CJ CJ>*CJCJEH CJEHCJ jCJU jCJUjJnoR CJUVaJ uhuuhu $ P$Ifa$ $ P$Ifa$$ hP$Ifa$m$$Ifl4 \x$h$64 la   lylylyly $ P$Ifa$ $ P$Ifa$$ hP$Ifa$j$$Ifl\x$h$64 la      9 yl $ P$Ifa$ $ P$Ifa$$ hP$Ifa$j$$Ifl\x$h$64 la9 : ] ^ _ o p  ylyyly $ P$Ifa$ $ P$Ifa$$ hP$Ifa$j$$Ifl\x$h$64 la |ylyyly $ P$Ifa$ $ P$Ifa$$ hP$Ifa$j$$Ifl\x$h$64 la         {rrpppr$ Pa$j$$Ifl\x$h$64 la $ P$Ifa$ $ P$Ifa$ (&P1h/ =!"#$%j4Dd ;P   S A ? 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