HomeMy WebLinkAboutALL DOCS - 12-00334 - The Medicine Shoppe - Signby E-mail $ign Permil Applic-=-*.-::]:i-i*o*:*i:;i
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Phone;
fox.'2O8.359.
Fixed $ignage
PrpferlieE)Owftsr,filare.:
Site Address:167W. MEh St
Mailing Address:167W" ftlain Sl
Telephone:{20o} 35e4481 Mobile:
C"ontractor Inf ormation
COntractor's Natne: Lylle Slgnr, Inc.
Contract6rrs Address: P.O, Box 3{l$
Contractor's Phone: (208)7ilL1739 Mobile:
ElectricaUSpecielty Contractor litformatlon (For powered or llthted slgnsl
Contrastor I nformation
ContractorrS Name: Lyile Sigm. lnc.
Contracto/s Address: P.O. BcE( 3os
Contracto/s Phone:
Contracto/s Signature:
Sign lnfonnation
Sign Area sq. ft:
Sign Description:
city/state/Zip:Twin Fdb.lO 8330+0305
City/State/Zip:Rexburg, lD 83440
City/State/Zip:Twin Fdlr. lD 83303{305
73+1739 Moblle:
Date: JuV31,?012
Wsll-z5 & 36sqruOircclional.4.S & 3,9$qfl Sign Height (from groundll Wall-12'& ldoaMlirectiqml-4'oeh
(2) Inbrnaly illjmlmtsd channel lattor dl€pL.F & (2) nofr.illuninalsd dh€cuoflal signa {por,attadad druvhgls)
it b mrnddory thstyou have the followlng Infomatlsn;
l.
2.
3.
4.
2 Set* of clevatlon drawlngs of a $Un & laror orot$ tfoorri@Dhl
Drawn to scalewith dimenglonr ond csmplele congtructlon materiEk
Footingr iJ apFlFable
Enginser rtempod lf rcquired
BEEsT,lttlDlNG i[lll
tr PLOT FI.AI{ TO SCALE SHOWING
trAl BUltDrNG [OcAr|oN
o B) [Or slzE
Bclt{R rstcilrocATloN
w-+u.sGNt
E Al SQ FO0TA6E OF WAU [Sr6fv Offl
tr BlEXrsnr{GsrGNS&AREAg cl rilEw $ei{ & AR€A
E o) rocnnou oF st6t{ or{ wArL
trDl DIMCNSIONS To slGN FROM PROPERTV UilEs E El 15 5l6N I.IGHTED? IES lmcs? maetsfore eleclrlml (r,de)
F El FARKII{G LOT EtITruWCE$ tsrBn must ic Ia IqoI wn hr fiEhttnq oN r'riel
EIFI O TAT'ICE OF SI6N FROM RIGHT OT WAY
E6' EXrSnHc srGNS TOCATtOil & AREA
tr tl, lS $l6N LlGtffE0? YES fnuri msst slot€ cr*trkal $de| fslgn rnost fe in kgal zorlc fu lbfting otrd qtpeJ
FG*: Sloo. - $?5.00 nfundrHr rt dmr otiln l hupccdon erd phdo of cornplatrd sl3n.'An extra $65"m chargowill be to ang pourcrcd or l$hted iign-
Signature of Applicant:Dgts3 July 31,2012
Not€: Thk documert is for apFllcddon proporer only {tfte legel slsn permil form m|.trt bo slgned by city ollichlr bcfore rlgn h ap'prwedl
5m t[n Ordlnencr l0Zll st wran.re.xburr.on for fpgulation information.
For Oflico Usc Only:
RccciptCodcs;(lcgular)[ IFC=$t5.00 t] l"/Sl]f?5.ffi(ForlilcctricnlA<ll) t I EI-EC=$40.00
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NDISAPPROVED"o** APPLIGABLT'
itton REQUIRED:
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Pharmacy Entrancedirectional 2' behindback edge of sidewalk
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Main St
CLAIM FORM
VENDOR #
VENDOR NAME
2nd LINE NAME
ADDRESS
CITY, STATE, ZIP
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DH APPROVAL
CITY OF
REXBIIRG
Americai Familv Communitv
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DESGRIPTION ACCT#ACCT DESCRIPTION AMOUNT
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CLAIMANT OR HIS AGENT SIGN HERE
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City of Rexburo
35 Northlst EasfRexburg, fD 83/t4O
208-359-3020 l
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Transaction taken by: shellie****'*-*;*: r ;,*-*.; : T::;-_**
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Billing- Informationytrfll s tct ts I tt c,vref 5 16 11g
,83303 t1-b
Transaction detailfor"" %ate : 08t 0r t 20t z - i z:gor?oTransaction Number: GsaessspTVisa - XXXX-X[X-XXXX-808 IStatus: Successful
PZ PLAN CHECK FEE
Ngtes: PERMtT12OO334
https ://www.xpressbillpay.com/common/payment process.php
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! Transaction detail for to Citv of
Site Secured by - Starfield Tecnno,ogies lnc.
Page I ofl
City of Rexburg (10006)
Transactionl'tumoeilEiEssepr-visa - XXXX-XXXX_XXXX_8081
Status: Refunded - Refun'ed
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Transaction taken by: marianna
Security I Contact Us I privacy policy
O Capyright 2003 - 20.13 Xpre$ giil pay LLC
ion Detaia
Transaction
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Description
JPZ SIGN DEPOSIT
Billing lnformation
VITAL SIGNS INC VITAL SIGNS
, 83303
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'i1' -Yl, lll_llrt*r .3 I F,intEr Forroat
5-7s.aa
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tA 3/4' O.D. x .j65 WALL15'-6" LONG
BELL BOX I€ED ACCESSFOR SERVICE IN STONE
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24" MIN DEPTH
CONCRETE BASE IS 5'x 6'd x 2'2 l/4 cu yd TOTAL
(-I.IATI16PP55 USE PROO(JCTION AIU^-OrR DISPLAY SFIALL REISER T}E II\FRIIIGER LIABI-E FOR I.PI?+lffi.Tgg,trI"tjl9F, 3^ryS"'iir-omFsfts A^D cosrs FoR EAcFr rrwRrrlcrvENr
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Date: 08t01t2Otz - ii:SO.zo
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:*--'-*.> Transaction detail for I_- .rayment to City of Rexburg.
Transaction NumOer: t63+69OgpTVisa - XXXX-XXXX-XXXX_808{
Status: Successfut
PZ SIGN DEPOSIT
Billilg Information
Y{TAL S IGNS I NC,VljrAr S ICruS
,83303 tq.c ffi
Transaction taken by: shellie
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Receipt Number:1?,V?ts
35 North tst eastTRexoG, tD. 83440
Phone (208) 359-3020 | Fax(208\ASg_g022
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12 00334
12 00334
12 00334
RPRRXBlO4C
RPRRXB1O4C
RPRRXB1O4C
$7s.00
$25.00
$65.00
Total:
$75.00
$25.00
$6s.00
Sign Deposit
Sign Permit
Permit - Electrical
$0.00
$0.00
$0.00
$165.00m
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