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mod' <br /> ermit Number: 03_6 0 7 v'ci <br /> Planning Department <br /> atY or g p <br /> ElkSign Permit Application Form <br /> River (One Per Sign) <br /> Property Information <br /> Address: 6/// /02 i i✓/ 577" Parcel Number: 75- - <br /> Legal Description: (attach if necessary) <br /> • <br /> Ap.I' ant t. _ <br /> �� �P �/,/In p S <br /> Name: ay♦"VP ,r�� TA ( l/t/C L l� <br /> Address: G t/f• At/t,w . 10114)eV Ittit -C 3311 <br /> Street City State ZipCode <br /> Phone(w): 7f 3 j 1 Fax: Phone(H): <br /> zy/-$.373 <br /> Signature: /` Date: y/4"7/3 <br /> Owner Infor tion f� <br /> Name: I 17-1 it-/j ) <br /> Address: ! I l/ `j l a ?J • �,' 1t)-e )l 4 7/3 7 ó <br /> Street City State ZipCode <br /> Phone(w): ?47 T 3 03,1 Fax: ` Phone(H): <br /> 11111 Signature: {'�. Date: trio <br /> I hereby certify that I have furnished information on this a.p ication,`hick is to the best of my kn. I dge true and <br /> correct. I also certify that I am the owner or authorized agent for the above-mentioned property 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 120 days,or if construction or work is suspended or abandoned for a period of 180 <br /> days at any after work is commenced. <br /> Submittal Requirements <br /> o Completed Application <br /> o Site Plan of Property Showing Sign Location <br /> o Building Elevations(Wall Signs) <br /> ❑ Plans and Specifications <br /> • <br /> Sign Information <br /> Sign Type: Wall —Free Standing _Temporary <br /> Ie�� Date(s)of Display: <br /> Sign Size: Width:Z:1 Height: — Square Feet <br /> Sign Message: 2/2.I- X /S 5Z.,#( ST e art S U/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: $150.00 <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 /> 0z( .Y <br /> Planning Depar ent to Building Department Date <br />