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[null,"This form requests structure numbers for bridges, signs, and high mast light poles.  This form does not apply to traffic signal mast arms (TSMAs).  For TSMAs, work with the local coordinator listed on the sheet \"Email.\"\n\nComplete the cells in yellow, and click the button below."]
[]
[]
[]
[]
[]
[null,"Structure Number Request Form No. 850-000-28, 02-12-2020"]
[null,"Name, Submitter:",null,null,null,"Date: "]
[null,"Email address:",null,null,null,"Phone No.: "]
[null,"Engineer, EOR:"]
[null,"Firm:"]
[null,"Firm Address:"]
[]
[null,"Data submitted must be for proposed, not existing structure."]
[null,"The plan and elevation sheet must be included with this request form."]
[null,"Data shall be accurate but may be estimated for items not yet determined.  If estimated, so indicate."]
[]
[null,"NBI","Item Description",null,"Item Code / Comment",null,"Coding Help"]
[null,"Item"]
[null,1,"FIPS State/Region",null,"12-Florida/4-Atlanta"]
[null,2,"District"]
[null,null,"FDOT Financial Project Numer"]
[null,3,"County",null,null,null,"See Coding Guide Tab"]
[null,"6a","Feature intersected",null,null,null,"See Coding Guide Tab"]
[null,7,"Facility Carried",null,null,null,"See Coding Guide Tab"]
[null,9,"Location",null,null,null,"See Coding Guide Tab"]
[null,11,"Mile Point, Route on the Structure"]
[null,11,"Mile Point, Route under the Structure",null,null,null,"If Applicable"]
[null,"13a/b","LRS Inventory Route on Structure",null,null,null,"Section/Subsection"]
[null,"13a/b","LRS Inventory Route under Structure",null,null,null,"Section/Subsection"]
[null,21,"Maintenance Responsibility",null,null,null,"See Coding Guide Tab"]
[null,22,"Owner",null,null,null,"See Coding Guide Tab"]
[null,26,"Functional Class, Route on the Structure",null,null,null,"See Coding Guide Tab"]
[null,26,"Functional Class, Route under the Structure",null,null,null,"See Coding Guide Tab"]
[null,41,"Open/Posted/Closed",null,"F=Proposed",null,"For bridge only"]
[null,"42a","Type of Service, Route on the Structure",null,null,null,"See Coding Guide Tab"]
[null,"42b","Type of Service, Route under the Structure",null,null,null,"See Coding Guide Tab"]
[null,"43a","Main Span Material",null,null,null,"See Coding Guide Tab"]
[null,"43b","Main Span Design",null,null,null,"See Coding Guide Tab"]
[null,48,"Legth of Maximum Span (ft.)",null,null,null,"For bridge only"]
[null,49,"Structure Length (ft.)",null,null,null,"For bridge only"]
[null,52,"Deck Width (out to out, ft.)",null,null,null,"For bridge only"]
[null,null,"Local Bridge Name",null,null,null,"For bridge only"]
[null,null,"Type of Sign (If Applicable)",null,null,null,"See Coding Guide Tab"]
[null,null,"Bridge Height",null,null,null,"See Coding Guide Tab"]
[null,null,"Bridge Use",null,null,null,"See Coding Guide Tab"]
[null,"8x","Previous (Existing) Structure Number",null,null,null,"If replacement"]
[null,8,"New Structure Number Assignment",null,null,null,"Assigned by FDOT"]
[]
[null,null,null,null,{"$f":"IF(E21=\"\",\"(Choose District No. at row \"&ROW(E21)&\")\",VALUE(MID(E21,1,2)))","v":"(Choose District No. at row 21)"}]

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["NBI"]
["Item No.","Item Description","Coding Guide"]
[2,"District","01 District 1"]
[null,null,"02 District 2"]
[null,null,"03 District 3"]
[null,null,"04 District 4"]
[null,null,"05 District 5"]
[null,null,"06 District 6"]
[null,null,"07 District 7"]
[null,null,"08 District 8"]
[3,"County","See Chart Below"]
["6a","Feature intersected","Record the names of the features intersected by the structure (Alligator Creek)"]
[7,"Facility Carried","Record the facility carried by the structure (US331, SR83, SCLRR)"]
[9,"Location","Narrative of location keyed to distinguishable feature (road junction).  Attach copy of location site map"]
[21,"Maintenance Responsibility","01 State Highway Agency"]
[null,null,"02 County Highway Agency"]
[null,null,"03 Town or Township Highway Agency"]
[null,null,"04 City or Municipal Highway Agency"]
[null,null,"11 State Park, Forest, or Reservation Agency"]
[null,null,"12 Local Park, Forest, or Reservation Agency"]
[null,null,"21 Other State Agencies"]
[null,null,"25 Other Local Agencies"]
[null,null,"26 Private (Other than Railroad)"]
[null,null,"27 Railroad"]
[null,null,"31 State Toll Authority"]
[null,null,"32 Local Toll Authority"]
[null,null,"33 Turnpike"]
[null,null,"60 Other Federal Agencies (Not Listed Below)"]
[null,null,"62 Bureau of Indian Affairs"]
[null,null,"63 Bureau of Fish and Wildlife"]
[null,null,"64 US Forest Service"]
[null,null,"66 National Park Service"]
[null,null,"67 Tennessee Valley Authority"]
[null,null,"68 Bureau of Land Management"]
[null,null,"69 Bureau of Reclamation"]
[null,null,"70 Corps of Engineers (Civil)"]
[null,null,"71 Corps of Engineers (Military)"]
[null,null,"80 Unknown"]
[22,"Owner","Use same codes as item 21 (Maintenance Responsibility)"]
[26,"Functional Class (Route On Structure)","01 Rural Principal Arterial - Interstate"]
[null,null,"02 Rural Principal Arterial - Other"]
[null,null,"06 Rural Minor Arterial"]
[null,null,"07 Rural Major Collector"]
[null,null,"08 Rural Minor Collector"]
[null,null,"09 Rural Other"]
[null,null,"11 Urban Principal Arterial - Interstate"]
[null,null,"12 Urban Principal Arterial - Other Freeways or Expressways"]
[null,null,"14 Urban Principal Arterial - Other"]
[null,null,"16 Urban Minor Arterial"]
[null,null,"17 Urban Collector"]
[null,null,"19 Urban Local"]
["42a","Type of Service On Bridge","1 Highway"]
[null,null,"2 Railroad"]
[null,null,"3 Pedestrian - Bicycle"]
[null,null,"4 Highway & Railroad"]
[null,null,"5 Highway & Pedestrian"]
[null,null,"6 Overpass Structure at an Interchange or Second Level of a Multi-level Interchange"]
[null,null,"7 Third Level of a Multi-level Interchange"]
[null,null,"8 Fourth Level of a Multi-level Interchange"]
[null,null,"9 Building or Plazas"]
[null,null,"0 Other"]
["42b","Type of Service Under Bridge","1 Highway with or without Pedestrian"]
[null,null,"2 Railroad"]
[null,null,"3 Pedestrian - Bicycle"]
[null,null,"4 Highway & Railroad"]
[null,null,"5 Waterway"]
[null,null,"6 Highway & Waterway"]
[null,null,"7 Railroad & Waterway"]
[null,null,"8 Highway & Waterway & Railroad"]
[null,null,"9 Relief for Waterway"]
[null,null,"0 Other"]
["43a","Main Span Material","1 Concrete"]
[null,null,"2 Concrete Continuous"]
[null,null,"3 Steel"]
[null,null,"4 Steel Continuous"]
[null,null,"5 Prestressed/Post-Tensioned  Concrete"]
[null,null,"6 Prestressed/Post-Tensioned Concrete Continuous"]
[null,null,"7 Wood or Timber"]
[null,null,"8 Masonry"]
[null,null,"9 Aluminum, Wrought Iron, Cast Iron"]
[null,null,"0 Other"]
["43b","Main Span Design","01 Slab"]
[null,null,"02. Multi-Beam or Multi-Girder"]
[null,null,"03 Girder-Floor beam or Girder-Floorbeam-Stringer"]
[null,null,"04 Tee Beam or Double Tee Beam"]
[null,null,"05 Box Beam or Box Girders, Multiple Boxes or Box Girders in contact"]
[null,null,"06 Box Beam or Box Girders, Single or Spread (Multiple Boxes or Box Girders spaced apart)"]
[null,null,"07 Frame (except Frame Culverts)"]
[null,null,"08 Orthotropic"]
[null,null,"09 Truss - Deck"]
[null,null,"10 Truss - Thru or Pony"]
[null,null,"11 Arch - Deck"]
[null,null,"12 Arch - Thru"]
[null,null,"13 Suspension"]
[null,null,"14 Cable Stayed Girder"]
[null,null,"15 Movable - Lift"]
[null,null,"16 Movable - Bascule"]
[null,null,"17 Movable - Swing"]
[null,null,"18 Tunnel"]
[null,null,"19 Culvert (includes Frame Culverts)"]
[null,null,"21 Segmental Box Girder"]
[null,null,"22 Channel Beam"]
[null,null,"00 Other"]
[null,"Bridge Height","High Level (over 45')"]
[null,null,"Medium Level (20' - 45')"]
[null,null,"Low Level (less than 20')"]
[null,"Bridge Use","Carrying two way traffic"]
[null,null,"Left of twin bridges (One way traffic)"]
[null,null,"Right of twin Bridges (One way traffic)"]
[null,null,"Ramp (One way traffic)"]
[null,"Type of Sign (if applicable)","Truss"]
[null,null,"Cantilever"]
[null,null,"Butterfly"]
[null,null,"Monotube"]
[3,"County","01 Charlotte"]
[null,null,"02 Citrus"]
[null,null,"03 Collier"]
[null,null,"04 Desoto"]
[null,null,"05 Glades"]
[null,null,"06 Hardee"]
[null,null,"07 Hendry"]
[null,null,"08 Hernando"]
[null,null,"09 Highlands"]
[null,null,"10 Hillsborough"]
[null,null,"11 Lake"]
[null,null,"12 Lee"]
[null,null,"13 Manatee"]
[null,null,"14 Pasco"]
[null,null,"15 Pinellas"]
[null,null,"16 Polk"]
[null,null,"17 Sarasota"]
[null,null,"18 Sumter"]
[null,null,"26 Alachua"]
[null,null,"27 Baker"]
[null,null,"28 Bradford"]
[null,null,"29 Columbia"]
[null,null,"30 Dixie"]
[null,null,"31 Gilchrist"]
[null,null,"32 Hamilton"]
[null,null,"33 Lafayette"]
[null,null,"34 Levy"]
[null,null,"35 Madison"]
[null,null,"36 Marion"]
[null,null,"37 Suwannee"]
[null,null,"38 Taylor"]
[null,null,"39 Union"]
[null,null,"46 Bay"]
[null,null,"47 Calhoun"]
[null,null,"48 Escambia"]
[null,null,"49 Franklin"]
[null,null,"50 Gadsen"]
[null,null,"51 Gulf"]
[null,null,"52 Holmes"]
[null,null,"53 Jackson"]
[null,null,"54 Jefferson"]
[null,null,"55 Leon"]
[null,null,"56 Liberty"]
[null,null,"57 Okaloosa"]
[null,null,"58 Santa Rosa"]
[null,null,"59 Wakulla"]
[null,null,"60 Walton"]
[null,null,"61 Washington"]
[null,null,"70 Brevard"]
[null,null,"71 Clay"]
[null,null,"72 Duval"]
[null,null,"73 Flagler"]
[null,null,"74 Nassau"]
[null,null,"75 Orange"]
[null,null,"76 Putnam"]
[null,null,"77 Seminole"]
[null,null,"78 St. Johns"]
[null,null,"79 Volusia"]
[null,null,"86 Broward"]
[null,null,"87 Dade"]
[null,null,"88 Indian River"]
[null,null,"89 Martin"]
[null,null,"90 Monroe"]
[null,null,"91 Okeechobee"]
[null,null,"92 Osceola"]
[null,null,"93 Palm Beach"]
[null,null,"94 St. Lucie"]

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["TO UPDATE THIS CONTACT LIST, EMAIL CHANGES TO andrew.devault@dot.state.fl.us"]
[null,"TO:","CC #1:","CC #2:","CC #3:","CC #3:"]
["District 1","Douglas.Torres@dot.state.fl.us","Daniel.Buidens@dot.state.fl.us","Michael.Rima@dot.state.fl.us","D1Inspections@wwebber.com"]
["District 2","Ruth.Findley@dot.state.fl.us","Stanley.Henderson@dot.state.fl.us","Jennifer.Wiggins@dot.state.fl.us","Shelley.Clayton@dot.state.fl.us","Desirea.Ouellette@dot.state.fl.us"]
["District 3","Phillip.Griffith@dot.state.fl.us","Steven.Fisher@dot.state.fl.us","Sarah.Evans@dot.state.fl.us","Jason.Gentry@dot.state.fl.us"]
["District 4","Patrick.St.Fort@dot.state.fl.us","Jose.Rexach@dot.state.fl.us","Kelley.Hall@dot.state.fl.us"]
["District 5","douglas.shockley@dot.state.fl.us","robert.mcquarrie@dot.state.fl.us"]
["District 6","Pablo.Orozco@dot.state.fl.us","Giuseppe.Noto@dot.state.fl.us"]
["District 7","Noah.Joseph@dot.state.fl.us","Vincent.Collie@dot.state.fl.us","Tara.Rodrigues@dot.state.fl.us","D7Inspections@wwebber.com"]
["District 8","Aran.Lessard@dot.state.fl.us","Giuliana.Cox@dot.state.fl.us","Wassim.Ashy@dot.state.fl.us"]