MEMORANDUM	Missouri Department of Transportation

DATE:	February 4, 2022

TO:	"Name of District Engineer"

District Engineer

FROM:	"Name of Sender"

"Title of Sender"

SUBJECT:	District "District #" - Design

Route "Route #", "Name of County" County

"Description"

Job No. "Job Number"

Conceptual Study Report

REMARKS

Major Route	Minor Route

DESIGN TRAFFIC	CONCEPTUAL COST ($1,000’s)

ADT (Const.)	=	Right of Way:

ADT (Design)	=	Construction:

DHV	=

D	=

% Trucks	=

Operational (Posted) Speed	=

EXISTING FACILITIES

Beginning Log Mile	Pavement	Year Built	Roadbed Width	Min. R/W Width	Access Control
Width	Type

Existing Bridges

Bridge No.	Location	Type	Length	Width	Year Built	Condition Ratings
Deck	Super	Sub

PROPOSED DESIGN CRITERIA

Functional Classification	Design Speed	No. & Width Of Lanes	Roadbed Width	Right of Way
Width	Control

PROPOSED DESIGN

ACCIDENT DATA AND SAFETY ENHANCEMENTS

Project Accident Rate – <

A summary of accident data is attached. <

Statewide rate for a similar class of roadway - <

Locations within or adjacent to the project limits which are on the “High Severity Location Lists” in the TMS database - <

UTILITIES

ENVIRONMENTAL SUMMARY

____________________________

Recommendations or Comments:

Attachments

Approved by:

"Name", P.E.	District Engineer

February 4, 2022

cc:	Design Division

Construction and Materials Division

Traffic Division