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Lr Garfield County Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.earfield-countv.com SIGN PERMIT APPLICATION FORM APPLICANT Owner/Applicant pQ 27✓VVSi /-r&.7--17) 1- L Name: Z7-14/\-/ 20M 0g/f/G// Mailing Address: 4/5 EZ -/e C 4./C LL City: be4sirZ- Phone: ( 9 7) we - State: CO Zip Code: / E-mail: c/eCr/7 dauh/e ci/J/" 9,aec74i/`--moi f- - Cs" -1 Representative (Authorization Required) Name: Phone: ( Mailing Address: City: State: — Zip Code: E-mail: ) 03,4,-E-01.0- /6,- 1121o, SIGN INFORMATION Assessor's Parcel Number: 2 1_9 _3 - v ° - v Physical/Street Address: 0 04/3 G //0 Zone District: CO/1/1,CO/1/1,L/M Sign Height: /31 Sign Size (sq.ft): 5 x 7 Sign is Illuminated ©' %Sign is Located on the Same Property as the Associated Business 0.4 ***Applicant shall submit a detailed sign site plan, and a rendering of the proposed sign including specifications. Engineered drawings may also be required.*** I have read the statements above and have provided the required attached information which is correct and accurate to the best of my knowledge. jle>„ A .Z)(97N Signature of Property Owner Date OFFICIAL USE ONLY Permit Number: S 0' / 0 Fee Paid: $ j 4'© 74', .�, ($25 + $1 per square foot of sign area per side) Approval Date: /0.2 7- 2,1We �p