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Request As-Built Plans

PERSONAL INFORMATION NOTICE
Pursuant to the Federal Privacy Act (P.L. 93-579) and the Information Practices Act of 1977 (Civil Code Sections 1798, et seq.), notice is hereby given for the request of personal information by this form. The requested personal information is voluntary. The principal purpose of the voluntary information is to facilitate the processing of this form. The failure to provide all or any part of the requested information may delay processing of this form. No disclosure of personal information will be made unless permissible under Article 6, Section 1798.24 of the IPA of 1977. Each individual has the right upon request and proper identification, to inspect all personal information in any record maintained on the individual by an identifying particular. Direct any inquiries on information maintenance to your IPA Officer.

Name


Business Name


Your email


Daytime Phone


Address


City:


State:


Zip:


Type of Requester:

Attorney/Law Office
Caltrans Consultant/Contractor
Design/Engineering Company
Federal, State or Local Agency/Utility
Landowner
Law Enforcement
Military:

Other Describe


Areas of Interest:

County:


Route:


Post Mile (if known)


From:


To:


Description


Type of As-Built Plans:

Roadway
Structures

The distribution of structure documents considered to be confidential is restricted to permissible parties. If this plans request involves confidential structures, a Confidentiality Agreement is required.

Is this information being requested for pending or anticipated litigation in which Caltrans may be a party?