Nebraska State Highway Commission

Nebraska Department of Transportation 1500 Hwy 2, PO Box 94759, Lincoln NE 68509

Sarah Soula, Commission Secretary 402-479-4512 sarah.soula@nebraska.gov

Highway Naming Application	Date of Application:
Proposed name:	Memorial Highway Bridge
DOT-OI 60-01 Item 1	Highway segment or bridge (individual interchanges, rest areas, interstate segments, or previously named roads/bridges are not eligible. Please include location map.)
Location (both termini)
Sponsoring Organization (include cover letter)
Contact Person
Contact Information: mailing address
Contact Information: email address
Contact Information: phone number(s)
Local Jurisdiction(s) – Please list all affected county and/or city, and/or tribal, and/or contiguous state authorities.

DOT-OI 60-01 Item 2	Dated	Resolution from County:	Contact Person	Position/Title	Phone
Notes:
Dated	Resolution from County:	Contact Person	Position/Title	Phone
Notes:
Dated	Resolution from City/Village:	Contact Person	Position/Title	Phone
Notes:
Dated	Resolution from :	Contact Person	Position/Title	Phone
Notes:
Dated	Resolution from :	Contact Person	Position/Title	Phone
Notes:
DOT-OI 60-01 3a
Date of Death:
Notes:
DOT-OI 60-01 3b
Date of Birth: (if applicable)
Notes:
DOT-OI 60-01 3b(1)
Location of Birth: (if applicable)
Notes:
DOT-OI 60-01 3b(2)
Dates of Residence: (if applicable)
Notes:
DOT-OI 60-01 3b(3)
City/County of Residence: (if applicable)
Notes:
DOT-OI 60-01 3c
Briefly summarize how the proposed honoree is widely recognized across the entire State and has contributed to the betterment of Nebraska.
DOT-OI 60-01 3 d & e
Briefly list and describe contribution(s) to the State of Nebraska: