JULIE
Send To:        TEST01          Seq No: 2               Map Ref:

----------------------------- Ticket Information ------------------------------
PLANNING DESIGN REQUEST                   NEW TICKET

Ticket Number:        2618300007
Received Date:        07/02/26 10:02 AM   Transmission Date:  07/02/26 10:06 AM
Required By:          07/20/26 12:01 AM   Due By:             07/20/26 12:01 AM

---------------------------- Designer Information -----------------------------
Company Name:         COMPANY, FIRM OR HOMEOWNER NAME
Address:              ADDRESS STREET NAME OR PO BOX INFORMATION, SUITE/APT #
                      PLACE NAME, STATE ZIP CODE

Caller:               CALLER CONTACT NAME
Phone:                111-222-3333        Ext:                1234
Email:                emailaddress@emailaddress.com

-------------------------- Project Owner Information --------------------------
Company Name:         PROJECT OWNER COMPANY NAME
Contact Name:         PROJECT OWNER CONTACT NAME
Address:              456 OWNER STREET NAME, SUITE 200
                      PLACE NAME, IL 60000
Phone:                333-444-5555        Ext:                5678
Cell:                 444-555-6666
Email:                projectowner@emailaddress.com

----------------------------- Project Information -----------------------------
Type of Work:         Design - ROAD RECONSTRUCTION
Work Being Done For (Project Owner):      WORKING FOR NAME
Job Number:           123ABC456DEF789GHI

---------------------------- Location Information -----------------------------
State:                IL                  County: COUNTY NAME
Place:                PLACE NAME
Subdivision:          SUBDIVISION NAME
Address:              123                 Street: STREET NAME
Cross Street:         INTERSECTING STREET NAME

Area to be Designed: MARK INSIDE THE AREA DESIGNATED ON THE MAP. DESIGN AREA
    COVERS BOTH SIDES OF STREET NAME FROM INTERSECTING STREET NAME TO 500 FT
    NORTH.

Comments: PROJECT PLANNING FOR 2027 RECONSTRUCTION.

Attachment: https://julie.utweb.occinc.com/attachment-link-address

Map Twp:    121N    Rng:  22W     Sect-Qtr: 31-SW-NW-NE
Map Twp:    121N    Rng:  23W     Sect-Qtr: 36-SE
Map Twp:    132N    Rng:  26W     Sect-Qtr: 24-SE

Number of Locations: 1
Coordinates for each location:
Polygon 1
(43.1567159, -92.5125155) (43.1567785, -92.5068185) (43.1558863, -92.5068507)
(43.1559059, -92.5125853)

Ticket Link: https://julie.utweb.occinc.com/?TRG=6EIiKfIdGiFg8ge8f3

------------------------------ Members Notified -------------------------------
ABC01     MEMBER NAME 1
          Facility Type(s): ELECTRIC, STREET LIGHTS
DEFG02    NORTHERN ILLINOIS REGIONAL WATER RECLAMATION AND DISTRIBUTION DISTRICT
          Facility Type(s): WATER, SEWER SANITARY, SEWER STORM
GT1       MEMBER NAME 3
          Facility Type(s): COMMUNICATION (CABLE, TELEPHONE), FIBER OPTIC
