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Agency <br />Project Title <br />Date <br />Kittitas County Public Works <br />7/15/2022 <br />Type of Proposed Work <br />Project Type (Check all that Apply) <br />Roadway Width <br />Number of Lanes <br />❑ New Construction ❑ Path / Trail <br />❑ 3-R <br />32 <br />2 <br />❑ Reconstruction ❑ Pedestrian / Facilities <br />❑ 2-R <br />❑ Railroad ❑ Parking <br />❑ Other <br />❑✓ Bridge <br />Geometric Design Data <br />Description <br />Through Route <br />Crossroad <br />❑ Principal Arterial <br />❑ Principal Arterial <br />Federal❑Urban <br />❑ Minor Arterial <br />E] Urban <br />ElMinor Arterial <br />Functional <br />❑✓ Rural <br />❑ Collector <br />[:] Rural <br />❑ Collector <br />Classification <br />❑ NHS <br />❑✓ Major Collector <br />❑ NHS <br />❑ Major Collector <br />❑ Minor Collector <br />❑ Minor Collector <br />❑ Local Access <br />❑ Local Access <br />Terrain <br />❑✓ Flat [:]Roll ❑ Mountain <br />[:]Flat ❑ Roll ❑ Mountain <br />Posted Speed <br />50 <br />Design Speed <br />50 <br />Existing ADT <br />3851 <br />Design Year ADT <br />Design Year <br />2022 <br />Design Hourly Volume (DHV) <br />Performance of Work <br />Preliminary Engineering Will Be Performed By <br />Others <br />Agency <br />Consultant / County <br />75 % <br />25 <br />Construction Will Be Performed By <br />Contract <br />Agency <br />Contractor <br />100 % <br />% <br />Environmental Classification <br />❑ Class I - Environmental Impact Statement (EIS) <br />❑✓ Class II - Categorically Excluded <br />(CE) <br />❑ Project Involves NEPA/SEPA Section 404 <br />❑ Projects Requiring Documentation <br />Interagency Agreement <br />(Documented CE) <br />❑ Class III - Environmental Assessment (EA) <br />❑ Project Involves NEPA/SEPA Section 404 <br />Interagency Agreements <br />Environmental Considerations <br />DOT Form 140-121 Page 2 <br />Revised 0112022 Previous Editions Obsolete <br />