Fillable MaineDOT Interstate Logo Sign Application (State of Maine)

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MaineDOT Interstate Logo Sign Application (State of Maine)

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The MaineDOT Interstate Logo Sign Application (State of Maine) form is 1 page long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for State of Maine

BROWSE STATE OF MAINE (ME) FORMS

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MaineDOT Interstate Logo Sign Application
Please mail the application to:
MaineDOT, Attn: Susan Merriman, Right of Way Control, State House Station 16, Augusta, Maine 04330
Please enclose your payment of $500 per main line logo sign with your application, make checks payable to, Treasurer, State of Maine.
Eligible service establishments may not discriminate on the basis of race, religion, sex, nationality, or creed.
TYPE OF SERVICE Gas Food
Lodging Camping Attractions (One application per service)
Hours of Operations _______to_______ daily
NAME OF BUSINESS_________________________________________________________TELEPHONE # ________________________________
NAME OF APPLICANT________________________________________________________TITLE________________________________________
BUSINESS ADDRESS ___________________________________ CITY OR TOWN _______________ STATE __________ ZIP _______________
MAILING ADDRESS (If Different) __________________________ CITY OR TOWN _______________ STATE __________ ZIP________________
EMAIL ADDRESS______________________________________________________
BUSINESS
LOCATION
DATA
1. CLEARLY IDENTIFY INTERCHANGE (SELECT ONE) I-95 I-195 I-295 I-395 EXIT # _____
3.
1 DIRECTION
2 DIRECTION
If only one direction is selected, please specify which one:
NB SB
EB WB
Minimum Required Services (“X” Applicable services)
CERTIFICATION
I certify that the above statements are true and correct and will inform MaineDOT of any changes to the above
information that may affect the service provided. I understand that MaineDOT may make inquires or inspect to
ensure that the minimum requirements are being met.
Applicant Signature _______________________________________ Date __________________________________
2. DIRECTION OF TRAVEL TO BUSINESS FROM EXIT
GAS
Minimum hours of
operation from 7am to
8 pm, 7 days a week.
Licensed by the relevant
state or local agencies.
Water, oil and at least 2
grades of fuel.
Public restrooms.
Drinking water.
Convenience store must
indicate the brand of
gas.
FOOD
Serve food a
minimum of 2
meals per day, 6
days a week.
Licensed by the
relevant state of
local agencies.
Public restrooms.
LODGING
Open 7 days a
week.
Licensed by the
state of local
agency.
Public restrooms
Adequate off-
street parking for
patrons.
CAMPING
Open at least 3
consecutive
months per
year.
Licensed by
the relevant
state or local
agency.
Public restrooms
& potable water.
FOR
OFFICE
USE ONLY
MILEAGE ___________________________
SIGNS
MAINELINE RAMP ARROW
NORTHBOUND _________ ______ ________
SOUTHBOUND _________ ______ ________
EASTBOUND _________ ______ ________
WESTBOUND _________ ______ ________
North South East West
FOR OFFICE USE ONLY
Approved _______________ Denied ______________ Date ___________
R/W Control Tech.
Signature ___________________________________________ Date _____________
Comments:______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
FOR OFFICE USE ONLY
MILEAGE __________________________
SIGNS
MAINELINE RAMP ARROW
NORTHBOUND __________ _______ _______
SOUTHBOUND __________ _______ _______
EASTBOUND __________ _______ _______
WESTBOUND __________ _______ _______
ATTRACTIONS
Attendants on site
Regularly schedule
tours.
Continuous operation
for 3 consecutive
months
Adequate parking for
normal attendance.
Meets specific eligibility
guidelines developed by
MaineDOT
Public restrooms
Drinking water
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MaineDOT Interstate Logo Sign Application (State of Maine)

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Completed 28 January 2021

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