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Traffic Disruption Request

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Traffic Disruption Information
Has this request been previously registered with VT?
Yes. If yes, provide Request Registration Number:
No. Fill out the forms below. A Traffic Disruption Request Form must be submitted before a Traffic Disruption is approved. Registration of the disruption is the responsibility of the Virginia Tech Project Manager
If approved a Traffic Disruption Request Approval will be E-MAILED to you. Therefore, an email address is needed. The Traffic Disruption Request Approval should be printed and kept onsite by the APPLICANT and AGENT (listed below). This should ensure that work is being performed as approved.
Department Information
Select Your Department
University Planning, Design & Construction Buildings & Grounds
Transportation and Parking Utilities and Building Systems
Other, VT Affiliated Other, NOT Affiliated with VT
Applicant Information
APPLICANT (Group at Virginia Tech requesting work)
Property Owner: VT Dept./Co./Org.:
Project Manager: Title:
Address: Mail Code:
City: State:  Zip:
Email:  
*Main Phone #: *Cell #:
*Emergency #: *Fax #:
*Phone numbers should include Area Code (xxx-xxx-xxxx)
Agent Information
Agent (Company performing traffic control)
Same as Applicant above
Project Manager: Company.:
Address: Mail Code:
City: State:    Zip:
Email:  
*Main Phone #: *Cell #:
*Emergency #: *Fax #:
*Phone numbers should include Area Code (xxx-xxx-xxxx)
Miss Utility Information
Miss Utility must be contacted at 1-800-552-7001 at least 72 hours in advance of any digging, drilling, boring, excavation, or earth disturbance. If work is within 500 feet of a traffic signal, VDOT must be contacted as well.
Provide the name of the person who will be contacting Miss Utility. Same as Applicant above
Name: *Phone #:
Email: *Phone numbers should include Area Code (xxx-xxx-xxxx)
Description
I request permission to perform the following activity or activities:
General Information
Which of the following choices best describe the work to be performed?

Please Follow Site Plans Details Below

  • Roadway shoulder/bike lane closure; traffic control needed.
  • Roadway single lane closure; traffic control (including flagmen) needed.
  • Total roadway closure. All other options have been exhausted, at least 30 day notification has been provided, detour map submitted, and traffic control needed.
Site Plan
The following restrictions must be considered when applying for a traffic disruption application:

  1. Traffic disruptions during special events (move-in & move-out, commencement, football games, etc.) are not allowed unless all other options have been exhausted.
  2. Any disruption to vehicular traffic on Virginia Tech roads should comply with the Virginia Work Area Protection Manual.
  3. The 2007 Work Zone Safety Guidelines for Temporary Traffic Control pocket guide (Link) is also available and based on the 2005 Virginia Work Area Protection Manual
  4. Look Here for an example of a traffic control plan.
  5. See Here for Parking Restrictions
List grid reference from VT map that locates the site: (Map)
Name of Road Affected:
Between (Road Name):
And (Road Name):
Date/Time of Traffic Disruption: (Dates must be in format mm-dd-yy or mm-dd-yyyy)
From: Date: Time: :
To:Date: Time: :
Map

Please scroll in the window below to the location of the proposed traffic disruption. Then click and drag the traffic cone onto the site.