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Traffic Control Plan Form

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City of Springfield

Traffic Control Plan

Location of Work

Site Address:

Date:

Applicant:

Phone:

Owner:

Phone:

Contractor:

Phone:

Period of use or time of construction:

Start Date/Time:

Finish Date/Time:

Equipment:

Traffic Impacts:

Traffic Signal Turn off/on:

Criteria for City of Springfield Traffic Control Plan Submittals

Plan Submittal requirements:

Submit your Traffic Control Plan (TCP) with the following information on 8.5"x11" or 11"x17" paper.

Fill out and submit this form with your TCP.

The TCP shall be a legible hand drawing, or a computer aided design with the following information:

A vicinity map:

That includes the north arrow, road names, intersection/driveway access points, curb lines, the work zone, and any

special features such as buildings, access points, sight obstructions, that could affect the TCP.

Location:

Where will the TCP be active? This can be a line drawing of the work zone(s) and/or a map that clearly indicates where traffic

control devices will be placed, including spacing and cone tapers.

Attachments of the appropriate traffic control diagram(s) as shown in the current MUTCD and/or the ODOT Oregon Temporary

Traffic Control Handbook that reflect the work zone may be included as a standard reference.

ODOT's Traffic Control Handbook website:

See attached example Traffic Control Plan on listed website

Traffic Control Plan Form

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