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Otsego County Road Commission • P. O. Box 537 • Gaylord, MI 49734-0537 • (989)732-5202 APPLICATION FOR THE PLACEMENT OF A ROAD NAME SIGN Date of Application: Applicant’s Name (print): Mailing Address: Phone Number: Signature: New Sign: Private Road: Replacement Sign: Public Road: Road Name: Location of Road, Township: Section:_______ Brief sketch of road location and proposed sign location: (Please include name of intersecting road and approximate distances to adjacent crossroads.) The applicant is responsible for the cost of the road name sign: Cost of Sign: $215.00 This portion to be filled out by an Otsego County Road Commission Official: Signature of Date Approved: Sign Ordered: Copy to Applicant Copy to Denise @ Equalization File: road name, sign app.kmm ---PAGE BREAK--- Otsego County Road Commission • P.O. Box 537 • Gaylord, MI 49734-0537 • (989) 732-5202 APPLICATION FOR ROAD NAME ASSIGNMENT Date of Application: Applicant’s Name: Mailing Address: Phone Number: ( ) Cost of Sign: $215.00 Receipt ROAD NAME REQUESTED: (In order of preference, a minimum of three road names must be listed- no proper names.) Name of Intersecting Road: Location of Road, Township: Section: Public Private__________ NOTE: Applicant is responsible for obtaining the signatures of all individuals who own habitable structures along the road to be named. Each of those individuals MUST sign below to indicate their agreement with the name (attach additional page if necessary). EXCEPTION: If the road itself is owned by one or more individuals, only those owners have a legal right to name that road…no other signatures would be on this form. Return this form within 15 days of the “Date of Application” above. Please sign & print names. PLEASE ATTACH A BRIEF SKETCH OF ROAD/SIGN LOCATION and INCLUDE DISTANCE FROM NEAREST ROADS. This portion to be filled out by an Otsego County Road Commission Official: Road Name Determined: Comments: Signature of Official: Date Copies to: Post Office Township Supervisor Equalization Dept. Requestor Otsego Lake Twp. Fire Chief EMS Dispatch Sign Order File: road name, sign app.kmm