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The construction of the Garrison Dam and the creation of Lake Sakakawea drastically altered the original transportation system of the reservation. After construction of the dam, the government flooded 80 percent of the road system. It was necessary to build 230 miles of new highways at a cost of $3.2 million. The project was completed in the fall of 1954. (Shane, p. 24)

Today the people of the Fort Berthold Reservation have access to three major highways and the Interstate system. Highway 1804, the historic route of Lewis and Clark, borders the east river bank of the Missouri River. Its counterpart, Highway 1806, follows Highway 22 on the western border of the Fort Berthold Reservation. This highway along with Highway 200, serve as the main transportation routes for the communities of Mandaree, Killdeer, and Twin Buttes. The main northern transportation connection point between the eastern and western portions of the reservation is the Four Bears Bridge located west of New Town, North Dakota. The United States Army Corps of Engineers moved the Four Bears Bridge from Elbowoods after the construction of the Garrison Dam. To reach the southern portion of the reservation, residents sometimes have to drive a distance of about 100 miles to reach outlying communities. Original plans to construct a bridge on the southern part of the reservoir were tabled in favor of seeking support for replacement of the antiquated and narrow Four Bears Bridge. The replacement of the Four Bears Bridge was approved in the year 2000 and completed in 2005.