A. Pennsylvania Byways Application Worksheet

A. Pennsylvania Byways Application – Worksheet (This serves as a worksheet only and outlines the requirements needed to complete the application. An electronic application must be completed and submitted @ www.dot.state.pa.us, click on Other Links, click on Transportation Planning, click on Byways, click on Application-Electronic. The applicant needs to provide key information from each county/municipality that the byway passes through for Sections E-M)

Byway initiated by: Application or Legislative Act Number ______

A. Nominated By (Applicant-Governmental Entity) Governmental Contact Person: Address of Governmental Contact Person: ______Telephone: Fax: Email: ______

B. Byway Leader/Contact Information Ogranization______Contact Person: ______Address: ______Telephone: ______Fax: ______Email: ______

C. Name of Road ______Location or Road: ______Beginning Terminus: ______Ending Terminus: ______Actual Length ______Name of Proposed Byway ______

D. Circle the quality(ies) associated with the proposed Byway: Scenic Historic Cultural Recreational Archaeological Natural

E. List resources along the Byway route that support the quality(ies) circled above. (Attach separate sheets)

F. List additional resources along the Byway corridor. (Attach separate sheets)

G. Identify the Byway corridor boundaries, on a county map, and the location of the required qualities. (Attach map as a separate document)

H. Provide a strategy for maintaining and enhancing the qualities for which the Byway will be designated (Attach separate sheets).

I. Explain how the proposed Byway complement other regional economic and community development Strategies or long range plans and how it relates to the County(ies) comprehensive plan(s). (Attach separate sheets)

J. Attach resolutions of support from each municipality(ies) and county(ies) along the proposed Byway. Resolutions shall include a statement indicating each municipality’s intent to uphold the designation and maintain its qualities. K. Attach letters of support from each applicable Metropolitan Planning Organizations and/or Rural Planning Organizations and Tourism Promotion Agency(ies) that the Byway travels through. L. Attach letters of support from members of the PA Legislative districts whose districts are bisected by the proposed Byway.

M. If the Byway is on the Interstate System, Federal-Aid Primary (FAP) or National Highway System (NHS): Attach an ordinance or ordinances for each municipality demonstrating how the erection of new signs, displays or devices will be prohibited on the Byway in conformance with 23 U.S. Code §131(s). If using an existing ordinance, attach a resolution reflecting consent to enforce the prohibition set forth above and not to revise the ordinance without the prior written approval of the Department. Failure to do so may result in revocation of the designation. (A copy of a model ordinance and other Byways material are available at www.dot.state.pa.us. Select More Links, Select Transportation Planning, then Byways.) If you are unsure if the Byway is on any of the designated systems or request a copy of a Model Ordinance or for clarification regarding any requirement, you may contact PennDOT @ 717-787-0782 . On behalf of the municipality(ies), the applicant certifies that this application, information and documentation therein or required by the Department is accurate pursuant to 18 Pa. C. S. §4904, relating to false swearing to authorities. ______(Nominating Agency) By:______Title:______Date ______