/ Request for Exception to Compliance
with the Work Zone Safety and Mobility Rule
Region No. / Route:
District No: / County: / Program Yr.:
Section No: / Project No.:
ADT: / DHV: / Design Speed Limit:

The stated mobility goals of the Work Zone Safety and Mobility Policy are:

  1. Delays caused by work zones should not exceed more than 5 minutes per mile of project length with a maximum of 30 minutes above the normal recurring traffic delay.

  1. Queues caused by work zones should be no more than 1.5 miles beyond pre-existing queues.

Please check the appropriate box explaining the exception requested below:

Significant Route Project (ADT under 35,000): based on current impact analysis and construction strategies, the stated goals are not expected to be met. See attachments for details. (IDOT - District 1 Traffic Operations approval required)
Significant Route Project (ADT over 35,000): based on current impact analysis and construction strategies, the stated goals are not expected to be met. See attachments for details. (IDOT and FHWA approval required)
Completion of plans, specifications and estimate would be significantly impacted as a result of this policy due to the late stage of this project relative to the policy implementation. Schedule letting date is . (IDOT and FHWA approval required)

Attachments shall:

  1. Provide a brief description of the project.

  1. Include a brief discussion of strategies considered and the reasons these strategies will not be utilized, which could include a listing of pros/cons, cost, delays and queues.

  1. Describe the recommended strategies which will be utilized identifying if possible the delays and queues. The mitigation measures to reduce the impacts on the project will be fully described.

Submitted by District Representative: / Date:

Approved by:

Bureau of Safety Engineering / Bureau of Design and Environment / Bureau of Local Roads and Streets / D1-Bureau of Traffic Operations
Date / Date / Date / Date
Federal Highway Administration: / Date:

Attachment for Request for Exception to Compliance with the Work Zone Safety and Mobility Rule:

Route:
Section:
Location:
County:
Contract:
Letting:
Scope of work:
Facility type:
Area type:
Project length:
Project duration:
Program cost:
DA/TMP Approval
Temporary Traffic Control Plan: Strategies utilized (Applicable methods are marked):
Existing number of lanes:
Number of lanes maintained during construction:
Use of temporary widening
Use of night work
Permanent lane closures
Temporary/ Restricted Lane closure
Incentive/Disincentive clauses
Railroad coordination / Restrictions for special events
Improving and signing alternate routes
Detour
Pedestrian accommodations
Other (Specify)
Comments:
Transportation Operation Plan: Strategies utilized (Applicable methods are marked):
Speed limit reduction
Increased penalties for WZ violations
Signal Coordination
Turn restrictions
Coord. w/adjacent construction sites / Parking restrictions
State Police Hirebacks
Incidence response coordination
Other (Specify):
Comments:
Public Information Plan: Strategies utilized (Applicable methods are marked):
Media: Press Release/Web Page
Changeable Message Signs
Static Message Board / Brochures/Flyers
Other (Specify):
Comments:

Printed 10/16/2018Page 1 of 2D1 PD0012 (09/26/08)