HomeMy WebLinkAboutALL DOCS - 12-00501 - 374 E 4th N - Rexburg Orthodontics - SignCI'IY OF
E-mail Sign Permif Applicolion
35 N. lsr E.
Rexburg, ID 83440
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City of Rexburg
Phone: 208.359.3020
Fox: 208.359.3022
H-ppl icant I nfo rmalion
Fixed Signage
Owner Name:
Site Address: 3
Mailing Address: 5aa-<t'
Telephone: G56 - &7// Mobile:
City/State/Zip:
Contractor lnformation .F *Contractor's Name: / >e/( J/a52-n
Contractor's Address: tate/Zip:
Contractor's Phone: -%- 3/S-A Z;a Mobile:
Electrical/Specialty Contractor Information (For powered or lighted signs)
Contractor I nformation
contractor's Name: 5oo-ff /.ot-r/e---t
Sign Information
Sign Area sq. ft:
Sign Description:
.:,,Sign Height (from ground):ld tA ",2.A
For a $jg_!gg4qi! it is 44!gg9gt that you have the following information
2 Sets of elevation drawings of a sign & (plot plats if applicablel
Drawn to scale with dimensions and comolete construction materials
Footings if applicable
Engineer stamped if required
1.
2.
3.
FREE STANDING SIGN
/,/ EPLOI PLAN TO SCALE SHOWING
,-E a) guil-otNlG LocATtoN
/,E B) Lor slzE, trc) NEW SIGN LocATIoN
WAIL SIGNS
tr A) sa. FoorAGE oF WALL (s/6N oN)
E B) EXISTING sIGNs & AREA
tr c) NEW SIGN & AREA
tr D) LocATroN oF slGN oN WALL
E E) lS SIGN LIGHTED? YES (must meet state electrical code)E D) DIMENSIONS TO SIGN FROM PROPERTY LINES
E E) PARKING LOT ENTRANCES (sign must be in legol zone for lighting and type)
E F) DISTANCE OF SIGN FROM RIGHT OF WAY
EG) EXISTING sIGNs LocATIoN & AREA
E H) fS SIGN LIGHTED? YES (must meet state electricol code) (sign must be in legol zone for lighting and type)
Fee: $100* - 575.00 refundable at time of final inspection of completed sign.
*An extra $65.00 charge ed or lighted sign.
Signature of Applicant:z/ *s -/a
Note: This document is for application only (the legal sign permit form must be signed by city officials before sign is approved)
See Sign Ordinance 1027 at @.Icxbglg.olg. for regulation information.
For Office Use Only:
ReceiptCodes:(Regular)[ ] PZ:$25.00 [ ] PZSD:$75.00 (ForElectricalAdd) [ ] ELEC:$40.00
2/u11
CLAIM FORM
VENDOR #
VENDOR NAME
2nd LINE NAME
ADDRESS
CITY, STATE, ZIP
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WDHAPPROVAL
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CITY OF
RE,XBIIRG
Am er icab F ami Iy Co mm un ity
DESCRIPTION AGCT#ACCT DESCRIPTION AMOUNT
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CLAIMANT OR HIS AGENT SIGN I-{ERE
Receipt Number: 12-Od)4
35 North 1st East / Rexburg, lD. 83440
Phone (208) 359-3020 / Fax (208) 359-3022
12 00501
12 00501
Sign Permit
Sign Deposit
$2s.00 $25.00 $0.00
$75.00 $75.00 $0.00
total $1OOOO
Payment Gheck
Mefrrod Number
GHECK 005108 $ 100.00
Total: $100.00
PAID
Nov - 5 zotz
CIW OF REXBURG
Orbin tFlee
Amount
Aniiunt
Petdpermtlt*Parcel
: ',.... ..
Recolpt #
P revl o us : PQy m e nt H t stA ry',,1 ., Fee Olltcrlpllgn.Rearlpt,gle :,'1.Amount Pald
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