Form SFN19926 "Application for Installation of Tourist Oriented Directional Sign (Tods)" - North Dakota

Form SFN19926 is a North Dakota Department of Transportation form also known as the "Application For Installation Of Tourist Oriented Directional Sign (tods)". The latest edition of the form was released in October 1, 2018 and is available for digital filing.

Download a PDF version of the Form SFN19926 down below or find it on North Dakota Department of Transportation Forms website.

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Download Form SFN19926 "Application for Installation of Tourist Oriented Directional Sign (Tods)" - North Dakota

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APPLICATION FOR INSTALLATION OF TOURIST ORIENTED DIRECTIONAL SIGN (TODS)
North Dakota Department of Transportation, Maintenance
SFN 19926 (10-2018)
REF Number
PLEASE PRINT
Applicant Name
Telephone Number
Address
City
State
ZIP Code
Business Name
Exact Business Name (max number of letters, characters, and spaces is 32)
BUSINESS OR ATTRACTION INFORMATION
Principle type of business or attraction available at the destination
Normal hours of business
Yes
No
Is the business or attraction open on a year-round basis?
If no, a "CLOSED" plate is required at any time the business or attraction is closed for periods exceeding 14 days.
TYPE OF SIGN REQUESTED
Right turn direction
Left turn direction
Straight ahead
(Straight ahead signs limited to tee-intersections only)
Exact location of sign
side of ND Highway ___________
N
S
E
W
N
S
E
W
a distance of ____________ feet
from the nearest milemarker number
EXACT LOCATION OF BUSINESS
N
S
E
W
The intersection of the road going to the business is ________ feet
ND Highway ___________
Yes
No
Does the business, service or activity comply with all local and state laws and regulations?
I, the undersigned, accept the terms and conditions of the rules of the North Dakota Department of Transportation and the laws of
North Dakota and agree to fully comply therewith to the satisfaction of the North Dakota Department of Transportation. I
understand that the sign posts, when erected, become the property of the North Dakota Department of Transportation. I further
certify that all of the information stated in this application is true and correct.
Applicant's Signature
Date
Submit application and a check for $25 permit fee for each direction. Make checks payable to NDDOT.
APPLICATION FOR INSTALLATION OF TOURIST ORIENTED DIRECTIONAL SIGN (TODS)
North Dakota Department of Transportation, Maintenance
SFN 19926 (10-2018)
REF Number
PLEASE PRINT
Applicant Name
Telephone Number
Address
City
State
ZIP Code
Business Name
Exact Business Name (max number of letters, characters, and spaces is 32)
BUSINESS OR ATTRACTION INFORMATION
Principle type of business or attraction available at the destination
Normal hours of business
Yes
No
Is the business or attraction open on a year-round basis?
If no, a "CLOSED" plate is required at any time the business or attraction is closed for periods exceeding 14 days.
TYPE OF SIGN REQUESTED
Right turn direction
Left turn direction
Straight ahead
(Straight ahead signs limited to tee-intersections only)
Exact location of sign
side of ND Highway ___________
N
S
E
W
N
S
E
W
a distance of ____________ feet
from the nearest milemarker number
EXACT LOCATION OF BUSINESS
N
S
E
W
The intersection of the road going to the business is ________ feet
ND Highway ___________
Yes
No
Does the business, service or activity comply with all local and state laws and regulations?
I, the undersigned, accept the terms and conditions of the rules of the North Dakota Department of Transportation and the laws of
North Dakota and agree to fully comply therewith to the satisfaction of the North Dakota Department of Transportation. I
understand that the sign posts, when erected, become the property of the North Dakota Department of Transportation. I further
certify that all of the information stated in this application is true and correct.
Applicant's Signature
Date
Submit application and a check for $25 permit fee for each direction. Make checks payable to NDDOT.
SFN 19926 (10-2018)
Page 2 of 2
LOCATION SKETCH SPACE
(Submit sketch of highway showing proposed sign location and business location.)
CONTRACTOR'S INFORMATION (Must be included with submittal)
Contractor's License Number
Expiration Date of Contractor's License
Expiration Date of Contractor's Bond
Contractor's Signature
Date
Effective November 24, 2008, the Contractor shall be required to wear an ANSI/ISEA 107-2004 Class II high visibility garment
while within the highway right-of-way as per the requirements of 23 CFR 634.
DEPARTMENTAL USE ONLY
District
Permit Number
N
S
E
W
Permission is granted for the erection of the sign as described in this application.
District Engineer Signature
Date
SPECIAL INSTRUCTION: A copy of this permit must be furnished to the contractor selected to erect the sign, therefore, send the
contractor's copy to the sign applicant.
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