5.0 PCSR 06-27-2006 - Laserfiche WebLink

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Permit Number: c. ~':~ 2006 Sign Permit .ver Application Form Property Information Address: A~~licant Information Name: Address: Street Phone (w): Owner Information Name: Address: Street Phone (w): Fax: City State Zip Code Phone (I I): Signature: Date: I hereby certify that I have famished information on this application, which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the above-mentioned property and that all construction will confotm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that this permit can be revoked for just cause. Furthermore, I hereby agree that the City Official or designee may enter upon the property to perforrn needed inspections. This pemut becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. Submittal Requirements ^ Completed Application ^ Site Plan of Property Showing Sign Location ^ Building Elevations with Wall Signs ^ Plans and Specifications Fee Schedule 0 to 100 sgft ................$60.00 101 to 300 Square Feet:...$120.00 Over 300 Square Feet:......$200.00 Temporary Signs:...........$30.00 plus $100.00 Deposit*** ***Temporary Sign Permit Deposits are returned to the applicant once the City receives (within 30 calendar days of date removed) a request in writing for the deposit. See page 2. Sign Information Sign Type: Sign Size: Sign Message: Wall _ Free Standing _ Temporary...Date Installed Width: x Height: = Square Feet Parcel Number: 75 - - Fax: Signature: City State Zip Code Phone (I3): Date: Date Removed Planning Department Date Building Department Date C:\Documents and Settings\deeseberg\Desktop\Sign Permt Application Form-old.doc