Convex Mirror for Two County Roads ( text)

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DPW Form 41 (1) 11/20/14 County of Hawai'i DEPARTMENT OF PUBLIC WORKS ENGINEERING DIVISION INSTALLATION OF A CONVEX MIRROR FOR TWO COUNTY ROADS INSTRUCTIONS FOR APPLICANT: 1) Fill out top portion of form and sign at the bottom. 2) Mail to ENGINEERING DIVISION AUPUNI CENTER, 101 PAUAHI STREET, SUITE 7, HILO, HI 96720 APPLICANT: MAILING ADDRESS: NAMES OF COUNTY ROAD(S)/STREET(S) MIRROR TO BE LOCATED: FOR OFFICE USE ONLY This form shall be routed and processed in the following order: 1. ENGINEERING DIVISION: PHONE: The posted speed limit for the through street is miles per hour ( mph). Based on the posted speed limit plus 5 mph, American Association of State Highway and Transportation Officials (AASHTO) guidelines recommend sight distances of: feet to the right and feet to the left ❑ There is sufficient intersection sight distance in accordance with AASHTO guidelines and the applicant has been so notified by the attached letter. ❑ There is insufficient intersection sight distance in accordance with AASHTO guidelines. Corrective work by the applicable property owner(s) will be pursued following the provisions of Chapter 22, Section 22-2.2 of the Hawai'i County Code. The applicant has been so notified by the attached letter. ❑ There is insufficient intersection sight distance in accordance with AASHTO guidelines. Corrective work by the applicable property owner(s) is not practical or will not provide minimum intersection sight distance recommended by AASHTO guidelines. This form is forwarded to the Highway Division for further evaluation. 0 2. HIGHWAY MAINTENANCE DIVISION: Date: ❑ We are able to increase intersection sight distance, at a reasonable cost using in-house resources, to meet the minimum intersection sight distance recommended by AASHTO guidelines. The applicant has been so notified by the attached letter (copy sent to Engineering). ❑ We are unable to increase intersection sight distance, at a reasonable cost using in-house resources along the County road to meet the minimum intersection sight distance recommended by AASHTO guidelines. This application is forwarded to the Traffic Division for the installation of a convex mirror. M 3. TRAFFIC DIVISION: Date: Convex mirror will be installed and the applicant has been so notified by the attached letter (copy sent to Engineering). 0 Date: The undersigned understands that this form will be used for review purposes by the Department of Public Works. The installation of the convex mirror is subject to the approval of this request. Applicant will be notified by mail. By: Date: APPLICANT'S SIGNATURE County of Hawai'i is an Equal Opportunity Provider and Employer