Motorist Information Sign Program Application

* = required

Business Information

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Contact Information

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Business location address

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Business mailing address


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Business operation days & times



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January        February        March       
April        May        June       
July        August        September       
October        November        December       

Business Activity

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Describe Gas business
 Provide fuel, oil, water, tire repair (Tire repair may be off-premise)
 Provide restrooms, drinking water and phone
 Card lock facility open to all major credit cards
Describe Food business
 County Health Office approval
License #
 Inside seating for 20 people or more
 Parking for 10 vehicles or more
 Provide restroom facilities
 Provide phone
Describe Lodging business
 Licensed by WA Department of Health
License #
Number of rooms
Describe Camping business
 County Health Office approval
License #
 24-hour attendant on duty
Number of camping spaces
Describe Tourist Activity business
Describe tourist activity provided
Describe Recreation business (non-interstate highways only)
Describe Pharmacy business
 Within 3 miles of the state highway
 Opening time-hours, 7 days a week
 State registered Pharmacist on duty 24-hours a day, 7 days a week

*  I declare under penalty of perjury under the laws of the State of Washington that the information provided herein, concerning my business, its services, and operating hours, certify that the above statements are accurate and true. I also acknowledge that any discrepancy in such information discovered hereafter is cause for the Department of Transportation to revoke the motorist information sign permit and remove my logo sign.

Failure to meet these requirements or other MIS program criteria may result in the removal of a business's logo signs.