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METRO LANE CLOSURE FORM <br />DEPARTMENT OF <br />TRANSPORTATION <br />• Submit Form to MetroLC.DOT@state.mn.us. Submit planned lane closures at least 3 days prior to the lane <br />closure and unplanned closures as soon as possible. Roadway closures require 14 days advanced notice. <br />• Contact Dispatch by radio or by calling 651-234-7110 at both the start and end of the lane closure. <br />• Document intrusions and field modifications in your diary. <br />Closure 0 Metro ❑ Central Office Section/Office Construction <br />Highway # 10 Direction ❑ NB ❑ SB 0 EB 0 WB <br />Location START (include nearest intersection) 169/Ferry St/47 MP <br />Location END (include nearest intersection) 7th Ave MP <br />Type of Closure (check all that applv1 Duration <br />❑ Left Lane ❑ Right Lane ❑ Intermediate/Night <br />❑ Left Shoulder <br />❑ Left Turn Lane <br />❑ Left 2 Lanes <br />❑ On Ramp <br />❑ Reduced to 1 Lane <br />O Closed Intermittently <br />O Flagging Operation <br />❑ Other <br />❑ Right Shoulder <br />❑ Right Turn Lane <br />❑ Right 2 Lanes <br />❑ Off Ramp <br />❑ Reduced to 2 Lanes <br />❑ Short Term <br />0 Short Duration <br />Day or Night <br />❑ Day 0 Night <br />Permit Restriction <br />❑ No ❑ Yes Height (ft) <br />Width (ft) <br />Weight (ton) <br />Traffic Control <br />❑ Plan Set <br />❑ Field Manual Layout # <br />Planned modifications <br />❑ Mobile <br />❑ Long Term <br />❑ 24-Hour <br />Type of Work Set beams on the 4th Ave Bridge <br />Unplanned, reason <br />Is work outside of the hours permissible in the Lane Closure Manual? ❑ No 0 Yes <br />If yes, reviewed by Kevin Farraher Metro Work Zones Contacts Map (Internet Explorer ONLY) <br />Start Date 07/18/2022 Day Monday Time 11:30 PM <br />End Date 07/20/2022 Day Wednesday Time 5:00 AM <br />Submitted by Joe Krueger Date 07/12/2022 <br />Email Address joseph.krueger@state.mn.us Phone 651-775-1078 <br />Additional Comments ****Monday 11:30 PM to 5:00 AM and again Tuesday 11:30 PM to 5:00 AM**** <br />Date Received Time Received Dispatcher <br />Required Fields <br />eDOCS# 2269624 <br />Select information will be displayed at <br />www.Sllrnn.org Rev. 6/14/2019 <br />