To:	enter name, Right-of-Way Bureau Chief

Through:	enter name, Appraisal Section Manager, Right-of-Way Bureau

From:	enter name

Date:	select date

Subject:	Project ID: enter text

Project # : enter text

Project Designation: enter text

Reason/Justification for request: enter text
Parcel valuations to be prepared by consultant:	enter text
Parcel valuations prepared by MDT Staff:	enter text
Is the project located on a tribal reservation?	☐ Yes	☐ No
Does the project contain state or federally owned land?	☐ Yes	☐ No
If yes, which parcels:	enter text
Does project contain railroad owned land?	☐ Yes	☐ No
If yes, which parcels:	enter text
Does project contain off premise billboards?	☐ Yes	☐ No
If yes, are they parcelized on Right-of-Way plans?	☐ Yes	☐ No
What is the status of Right-of-Way Plans?	☐ Preliminary	☐ Final
If preliminary, when are the final plans expected? select date
Appraisal Authorization date: select date
Acquisition Authorization date: select date
Requested Appraisal Services due date: select date
Letting date: select date	Ready date: select date	Drop dead date: select date
Other documentation and/or information:
enter text
Appraisal Services Requested by MDT Legal Services: enter text