DEPARTMENT OF TRANSPORTATION STATE OF GEORGIA TIA PROJECT CONCEPT REPORT

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DEPARTMENT OF TRANSPORTATION STATE OF GEORGIA TIA PROJECT CONCEPT REPORT Project Type: GDOT District: Federal Route Number: State Route Number: P.I. Number: County: MPO ID Number: Project Description (provide a very brief description of the project) Submitted for approval: Local Government Representative District Engineer/Consultant & Firm TIA Project Manager GDOT TIA Regional Coordinator TIA Program Manager GDOT State TIA Administrator Approval: Concur: GDOT Director of Engineering Approve: GDOT Chief Engineer

PROJECT LOCATION Include a project location map sufficient to clearly locate the project and its beginning and ending point.

PLANNING & BACKGROUND DATA Project Intended Benefit: Benefit as stated in the regional project description Description of the proposed project: Other projects in the area: Federal Oversight: Exempt State Funded TIA Other MPO: TIA Regional Commission: MPO Project ID RC Project ID Congressional District(s) ##: Projected Traffic: (if necessary) ADT or AADT Current Year (20WW): Open Year (20XX): Design Year (20YY): Traffic Projections Performed by: Functional Classification (Mainline): Complete Streets - Bicycle, Pedestrian, and/or Transit Warrants: Warrants met: None Bicycle Pedestrian Transit Is this a 3R (Resurfacing, Restoration, & Rehabilitation) Project? No Yes DESIGN AND STRUCTURAL DATA - Delete table if not applicable to project Mainline Design Features: Roadway name/id - delete any rows in table that are not applicable. Feature Existing Standard* Proposed Typical Section - Number of Lanes - Lane Width(s) - Median Width & Type - Outside Shoulder or Border Area Width - Outside Shoulder Slope - Inside Shoulder Width - Sidewalks - Auxiliary Lanes - Bike Lanes Posted Speed Design Speed

Min Horizontal Curve Radius Maximum Super elevation Rate Maximum Grade Access Control Design Vehicle Pavement Type Additional Items as needed *According to current GDOT design policy if applicable Major Structures: (If no major structures on project, N/A and delete table below) Structure ID Existing Proposed Major Interchanges/Intersections: Lighting Required: No Yes Transportation Management Plan [TMP] Required: No Yes If Yes: Project classified as: Non-Significant Significant TMP Components Anticipated: TTC TO PI Will Context Sensitive Solutions procedures be utilized? No Yes Design Exceptions to FHWA/AASHTO controlling criteria anticipated: Design Variances to GDOT Standard Criteria anticipated: UTILITY AND PROPERTY Railroad Involvement: Utility Involvements: SUE Required: No Yes Public Interest Determination Policy and Procedure recommended (Utilities)? No Yes Right-of-Way: Existing width ft. Proposed width: ft. Required Right-of-Way anticipated: No Yes Undetermined

Easements anticipated: None Temporary Permanent Utility Other Anticipated number of impacted parcels: Total Displacements Anticipated: Businesses: Residences: Other: ENVIRONMENTAL DATA Anticipated Environmental Document: GEPA: Type A Letter Type B Letter NEPA: CE EA/FONSI Project Air Quality: (On-system projects only) Is the project located in a PM 2.5 Non-attainment area? No Yes Is the project located in an Ozone Non-attainment area? No Yes Is a Carbon Monoxide hotspot analysis required? No Yes MS4 Compliance Is the project located in an MS4 area? No Yes Environmental Permits/Variances/Commitments/Coordination anticipated (Include description of potential for 404 Permit, Stream Buffer Variance, and Section 4(f): NEPA/GEPA Comments & Information: (Describe anticipated effects to ecology, history, archeology, air & noise, public involvement, etc. & the effect on the environmental document)

PROJECT RESPONSIBILITIES Project Activities: Project Activity Concept Development Design Right-of-Way Acquisition Utility Relocation Letting to Contract Construction Supervision Providing Material Pits Providing Detours Environmental Studies, Documents, and Permits Environmental Mitigation Construction Inspection & Materials Testing Party Responsible for Performing Task(s) Other coordination to date: Project Cost Estimate and Funding Responsibilities: TIA Programmed Budget PE ROW Reimbursable Utilities CST Funded By TIA TIA TIA TIA Total Cost $17,690,438 Date of Estimate Estimated Amount Budget Contingency $135,807.50 $34,291.32 $127,656.14 $1,205,932.05 Total Estimated Cost Note: 1. Budget Contingency includes project contingency, program contingency, and program level of effort costs ALTERNATIVES Preferred Alternative: Estimated Property Impacts: Estimated ROW Cost: Rationale: Estimated Total Cost: Estimated CST Time:

Alternative 1: if applicable Estimated Property Impacts: Estimated ROW Cost: Rationale Estimated Total Cost: Estimated CST Time: Comments/additional information: Attachments: 1. Concept Layout 2. Typical sections 3. Cost Estimates 4. Crash summaries (if needed) 5. Traffic diagrams or projections (if needed) 6. Capacity analysis summary (if needed) 7. Signal Warrant Analysis (if needed) 8. Summary of TE Study (if needed) 9. Meeting Minutes 10. Signed Agreements 11. Other items referred to in the body of the report.