2000-17
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATIO-,
. TRAFFIC SIGNAL MAIN8ANCE & OPERATION REQUEST 01MER NO.
FORM 750-010-23
TRAFFIC ENGINEERING - 03/96
Page I of2
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D.O.T. DISTRICT NO.
5
COUNTY
Lake
MAINTAINING AGENCY
Citv of Clermont
1. All signals and signal systems covered by this request order are referenced to an agreement of record dated
12-9-86 between the Department and Maintaining Agency and no supplemental agreement is
required.
2. The Maintaining Agency is hereby authorized and requested to undertake the maintenance and operation of
1 signals or signal systems along the State Highway System as listed in PART C of this
request order. All previously numbered and dated request orders for these same locations are rescinded unless
specifically exempted as follows:
Identification of Type of Equipment and Installations to be Maintained and Operated (Part C is attached).
MAINTAINING AGENCY
ACKNOWLEDGED AND APPROVED:
Signature: ð(:~¿ -
Date:
c.¡. þ /ao
I'
Title:
City Manager
FLORIDA DEPARTMENT OF TRANSPORT AnON
ACKNOWLEDGED AND APPROVED:
Signature: M~../ / ~
Title~ District Traffic Qperations Engineer
Date:
4 h(JIho
, ,
NOTE:
Terms of Traffic Signal Maintenance Agreement remain in full force and effect and are not modified by this
document.
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
~ TRAFFIC SIGNAL MAIN8ANCE & OPERATION REQUEST OWER NO.
FORM 750-010-23
TRAFFIC ENGINEERING - 03/96
Page 2 of2
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INTERSECTION NO. STREET NAMES FIXED ACTUATED INTER- NO. OF OTHER*
TIME CONNECTED SIGNAL HEADS
SR 50 aI Citrus Tower Boulevard X
PART C
IDENTIFICATION OF TYPE OF TRAFFIC SIGNAL EQUIPMENT AND
INST ALLA TIONS TO BE MAINTAINED AND OPERATED
SPECIAL EQUIPMENT to be operated and maintained:
*DESCRlBE:
Copies:
District Traffic Operations (original)
Maintaining Agency
Document Control (MS 16)
RECYCLED PAPE8