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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: ( ) ROAD NAME REQUESTED: (list in order of preference) 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 (fifteen) days of the “Date of Application” above. Please sign & print names. PLEASE ATTACH A BRIEF SKETCH OF ROAD LOCATION and INCLUDE DISTANCE FROM NEAREST ROADS. This portion to be filled out by Otsego County Road Commission Official: Signature of Official: Date Approved: Copies to: Post Office Township Supervisor Equalization Dept. Requestor Otsego Lake Twp. Fire Chief road name report.kmm • revised 10/03/03 ---PAGE BREAK--- Otsego County Road Commission • P. O. Box 537 • Gaylord, MI 49734-0537 • (989)732-5202 APPLICATION FOR PLACEMENT OF ROAD NAME SIGNS PLEASE NOTE: When full payment has been made, the Road Commission will order and install the sign(s). The cost is the responsibility of the Applicant. Date of Application: Applicants’s Name (print): Mailing Address: Phone Number: Signature: Road Name: _____Public Private Location of Road: Brief sketch of road location and proposed sign location(s): (Please include name of intersecting road and approximate distances to adjacent crossroads.) Comments (O.C.R.C. Signature of O.C.R.C. Date Approved: Sign Ordered: Copy to Applicant Copy to Sandy @ Equal. road name report.kmm (revised 09/01/04)