PennDOT Engineering District [District]-##

[Response-Letter-Date]

Application No. [Application ID] County: [County-Name]

Status: [Application Status] SR: [State-Road] Segment: [Segment] Offset: [Offset]

[Applicant-Name]

[Applicant-Address-Line-1]

[Applicant-Address-Line-2]

[Applicant-City], [Applicant-State] [Applicant-Zip-Code]

Dear Applicant:

[Response-Letter-Text]