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U, Permit Number: 0;' ' 09(c 41 <br /> Planning Department <br /> City or <br /> El7�k J Sign Permit Application Form <br /> River (One Per Sign) <br /> Property Inf ormation <br /> Address: 6 Y/ 474-r/7 574- Parcel Number: 75- <br /> Legal Description: (attach if necessary) <br /> ���/ I <br /> Name: ryy wel,c <br /> f!ft— .fl ��}l�l'11 ` .) <br /> Address: 6, t/I• !'khinsJ . GIKI�iJW ait rpxi <br /> Street City State ZipCode <br /> Phone (w): 7( 3 ifigj ( , Fax: Phone(H): <br /> 2.VI-8373 <br /> Signature: - • a. Date: W/eVat3 <br /> Owner Infor a,thin n [ <br /> Name: Is '44 165 • ,!.(ifs .'JJ <br /> Address: 611/ in fn 11�D IJ? /A-5 7./776 <br /> Street City State ZipCode <br /> Phone(w): ?/a G31 /0.1 Fax: ! Phone (H):.' <br /> Signature: �r�'`;. Date: <br /> I hereby certify that I have furnished information on this a.p ication,`hich is to the best of my kn I ge true and <br /> correct. I also certify that lam the owner or authorized agent for the above-mentioned propert a that all <br /> construction will conform to all existing stare and local laws and will proceed in accordance with submitted plans. I am <br /> aware that this permit can be revoked for just cause. Furthermore,I hereby agree that the City Official or designee may <br /> enter upon the property to perform needed inspections. This permit becomes null and void if work or construction <br /> authorized is not commenced within 180 days,or if construction or work is suspended or abandoned fora period of 180 <br /> days at any time after work is commenced. <br /> • <br /> Submittal Requirement= <br /> ❑ Completed Application <br /> ❑ Site Plan of Property Showing Sign Location <br /> ❑ Building Elevations(Wall Signs) <br /> ❑ Plans and Specifications <br /> Sign Information <br /> Sign Type: (Wall _Free Standing Temporary <br /> Date(s)of Display: <br /> Sign Size: WidthS Height: - Square Feet <br /> Sign Message: 2 5-_ ,L X IT 5c,...re size 6S ore)..e.- <br /> Fee Schedule - • <br /> 0 to 100 Square Feet: $30.00 <br /> 101 to 300 Square Feet: $90.00 <br /> Over 300 Square Feet: S150.00 <br /> Temporary Signs: $50.00 Deposit <br /> Temporary Sign Permit Deposits are returned to the applicant once the City,receives a request in <br /> writing for the d posit. <br /> c4 . `�4c3.. <br /> Planning Depar ent Building Department Date <br /> • <br />