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Cl [Y OF
REXBURG
AMFKICAS FAMILY COMMUNITY
Application for Sign Permit
Fixed Signage
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Applicant Information
Date of Application: S" — 7 - V Permit Number:
Owner Name:
Site Address: `o
Mailing Address: City /State /Zip Q1� -�,_c
Telephone: Mobile:
Contractor Information
Contractor's Name:
Contractor's Address: � 2,7 4 J. r'!'�- City /State /Zip 1= „,�; `,mis�c.ftli WZ a J
Contractor's Telephone: W J ZT 1 ~ 7 7 S 1 Mobile: 2 V e 45 -t - d� i' k l
Sign Information
Sign area sq. fl: - J?. 9 2 Sign Height (from ground): / 3
Sign Descriptions: A4 N 4 ]Aa0k1, Al,t LEA
For a Sian Permit it is mandatory that you have the following information:
2 j jts of elevation drawines of a Bleu & (plot plats if applicable )
Drawn to scale with dimensions
And complete construction materials
Footings if applicable
Engineer stamped if required
FREE sl=I YG SIGN WALL SIGNS
u Plot Plan to scale showing: ❑ a) Sq. footage of wall (sign on)
❑ a) Building location c b) Existing signs & area
o b) Lot size o c) Now sign & area
o c) New sign location o d) Location of sign on wall
❑ d) Dimensions to sign from property lines o e) Is sign lighted? Yes (must meet state electrical code)
❑ e) Parking lot entrances (sign must be in legal zonefor lighting and type)
o f) Distance of sign from right of way
o g) Existing Signs location & area
❑ h) Is sign Lighted? Yes (must meet state electrical code) (sign mtcrt be in legal zone for lighting and type)
Fee: $100.00 - $75.00 refltndable at time of Anal inspection and photo of completed sign.
Signature of Applicant:
Note: This document is far application purposes only (the legal sign permit form must be signed by city officials before sign Is approved)
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CLAIM FORM
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CiTY OF
R-EXBUR-G
V ENDOR € -4g �� AMERJCXS FAMILY COMMUNITY
NAME ! (.I_ - 1 6 DATE
ADDRESS FED ID or SS# C�
GITY, STATE, ZIP ��Z .d 2 TELEPHONE. 03 --- 7 7 /
DESCRIPTION CODE AMOUNT. APPROVED
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