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."._,........ <br /> • Permit Number: 0 7j Q 0'7 4r cl <br /> Planning Department <br /> city or <br /> ElkSign Permit Application Form <br /> River (One Per Sign) <br /> Property Information / <br /> Address: 6 "/ /M., 5/ Parcel Number: 75- - <br /> Legal Description: (attach if necessary) <br /> AR' !A /��./ / )' <br /> Name: _t t ry f:j i"/�'i atA S{ J <br /> Address: G t�l mAi .d. G'I�11tJCV out S;c33X <br /> Street City State ZipCode <br /> Phone(w): f Fax: Phone(H): <br /> Zyi-g373 <br /> Signature: , ,e _ Date: e:10/477/r3 <br /> Owner Infor tion A /I ` <br /> Name: J ,e JIA-it 4f-1 we, 't. ` <br /> Address: G./// 4ia ?� �,l e J$ -5 31176 <br /> Street City State ZipCode <br /> Phone(w): 717 til /331 Fax: ! ,, Phone(II): <br /> • Signature: ir '`,: Date: <br /> I hereby certi fy that i have furnished information on this a.p ication,l hich is to the best of my kn.•I .ge 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 state 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 for a period of 180 <br /> days at any time 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 /> o Plans and Specifications <br /> Sign Information <br /> Sign Type: K Wall _Free Standing _Temporary <br /> Date(s)of Display: <br /> Sign Size: Width:�Height:_- Square Feet <br /> Sign Message: 2/Z r--1- k /8 5cevrt? Sim a,S 6,re) w- <br /> Fee Schedule <br /> • <br /> 0 to 100 Square Feet: $30.00 <br /> 101 to 300 Square Feet: 590.00 <br /> Over 300 Square Feet; $150.00 <br /> Temporary Signs: 550.00 Deposit <br /> Temporary Sign Permit Deposits are returned to the applicant once the City receives a request in <br /> writing for the d osit. y <br /> Plann n De Z_Zte/j <br /> g p �1 T+ Building Department Date <br /> e P <br />