Virginia Department of Transportation - PROJECT EARLY NOTIFICATION

Form EQ-429 Exempt from SERP

(Revised 9/24/03) No Permits Required

Virginia Department of Transportation - PROJECT EARLY NOTIFICATION

PPMS ID: / Route: / For use by Environmental staff only:
VDOT Project #: / Date received by Environmental:
VDOT Charge #: / IECC Notification Date:
City/County: / Deadline for agency response (30th day):
Zip Code: / Form submitted by:
Latitude/ Longitude (if known): / º ' " / Division/District/Residency:
º ' " / Date submitted to Environmental:
Project Limits (USGS topo map indicating termini required): / Is Local Government administering PE, R/W,
or Construction? / Yes No
From:
To: / Funding Source: / State Federal
Length of Project (feet/miles): / Target AdvertisementConstruction date:
Project description and comments (be as specific as possible):
Road Type: / Type of project: / Location of work:
Interstate / Construction / Work within existing corridor
Primary / Maintenance/Replacement / Changes to existing alignment
Secondary / Maintenance / Work on new location
Urban / Railroad
Other / Roadway work included: Yes No
Constructed by: State Railroad Co.

Road Conditions

/ Existing Conditions (must be completed) / Proposed Conditions (must be completed)
Pavement width (ft/m)
Number of traffic lanes
Right-of-way width (ft/m)
Additional information, include only if applicable to the proposed project:
Stream crossing (s) / Name of stream(s) crossed:
Drainage Area: <5 miles² ³5 miles² / Hydrologic Unit Code (if known):
Existing bridge(s)/drainage structure(s) / Type of bridge/structure (from HTRS): / Bridge/structure #: / Date constructed
(bridge only):
Public park(s) /forest(s)/ recreational area(s) / Name of facility: / Degree of impact (if known):
Review agency responses must be sent to (appropriate VDOT District SERP Coordinator, mailing address, phone number and email):
Agency comments (attach additional sheets as necessary)
State agencies are requested to provide available existing database information on the project described above within 30 days of this notification. Database information should be sent directly to the District SERP Coordinator indicated above.
VDOT will send review agencies a copy of the Preliminary Environmental Inventory (PEI) for this project unless indicated here that review of the PEI is not necessary: Our agency does not need to review the PEI. Please consider our early comments in project development.
Name: / Agency: / Date:

Project Number:

USGS Quad Name:

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