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I APPLICANT
SIGN PERMIT
APPLICATION FORM
------Representative (Authorization Required)
Name: M I c.f:!o 7>t..A'?""JC~.> (tJC , {bw1 C:..HT ~~At-)Phone: ( Cf.:tt:i ) qqs-e3o 9 I
Malling Address: 4 o ~ '2... 4 +V\ '5 'T.
City: ~ f... e? fJ \N i::o-D $ f ~ \ N~ S State: e._ t:> Zip Code: 8 l t.,. 0 I
E-mail: D \.-.J l ~Hi @ N ?S IStJ"J . ~6 lN\
---~ SIGN INFORMATION
Assessor's Parcel Number: <. _t _ _j_ > -7-'Z---S -6 C -.£__!_ ~
Physical/StreetAddress: '2. S-5D Hl.N~ ~~ uN"t -r '°t;,Z oo
Zone District: CC;r Sign Height: 143:'1 Sign Size (sq.ft): 4-0 • b~.,_
D Sign is Illuminated
'l;lJ Sign Is located on the Same Property as the Associated Business
. ------1 ... Appll~nt shall submit a detailed sign site plan, and a rendering of the proposed sign Including
specifications. Engineered drawi!'BS may also be r_eq_,_u_lr_e_d._*_**------~
I have read the statements above and have provided the required attached information which is
correct and accurat to the b y knowledge.
~.I~ IS-
Date
OFFICIAL USE ONLY -I
Permit Number: ~~ -'3£-o_,\9==--~----F-ee -Pa-ld-: $ &5-:~ . J
Approval _o_at_e_: -~-·_U_o_·_l_5_~ __ ($25 + $1 per square foot of sign area ~er sl ~
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