Structure Site Information
District:	1 - Bennington 2 - Dummerston 3 - Rutland 4 - White River Jct. 5 - Colchester 6 - Berlin 7 - St. Johnsbury 8 - St. Albans 9 - Derby
Town/City:
Route or Town Highway #:
Mile Marker/Bridge #/Location:
	(Please make sure the site is clearly marked with flagging and/or a grade stake.)
Structure Type:	Bridge Box Pipe Arch Other
Structure Size:
GPS Coordinants:
Proposed Due Date:
Contact Name:
Email:
Phone Number:
Comments: