HomeMy WebLinkAboutALL DOCS - 12-00285 - 160 W 2nd S #207 - Atrium - Sign()rnpietic)ft
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ermit Applicofion
City of Rexburg
Phone: 208.359.3020
Fox: 208.359.3022
Mobire: S8n-qtVq
contractor's N^e -aWcontractor'sLicense Numbet,C- I Zs rc - nn+- ,1,c- lssz
ContractofsAddress: tbB-x 3i3g, City/Srate/Zipz
contractor'sT"t"phr,n(.2f[,)'785-25h3 j\Iobite:
ItDate: 6 1t t/l t2..
Sign Height (from ground): rrt A
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Applicant Information
Ovner Name:
Site .\ddress:
Contractor Inform ation
Contractor's Name:
Contracto/s Address:
Contractor's Telephone:
Contractor,s
Sign Information
Sign area s<1. ft:
Sign Descriprions:
Fixed Signage
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MailingAddress: Snaaa ,ny/St^n/zip, PqLut-t Zt) &3/eC)
Telephone: ,'"51- /// Nrobite:
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Electtical/specialty conttactor Infotmation (For poweted or lighted signs)
contracror's Nn rr, L) fiU[$;f,lecTplcr Conrscror,s T.i..-"o r.r.,-x-.. d- i
For a stn Permir it is mandatory that you ha'e the following information:
2 eets of elevation drawinge of a sign & bhekx if a?pticvbh)Drawn to scale with dimensions and complete .ottrtntitio. matetialsFootings if applicable
Errgineer stamped if required
FREE STANDING SIGN
o Plot Plan to scale showing
n a) Btrildinglocation
n b) [,ot size
n c) New sign locetion
o cI) Dimensions to sigr frorn property lines
n e) Parking lot entrnnces
n f) Distance of sigr from right of way
n g) Existing Signs location & area
Signature of A
WALL SIGNS
n a) h. footage of wall $ign on)
n b) Existing signs & area
$c) New sign & atea' I d) Location of sign on wall
;fe) ls sign lighred? Yes (mnil meet strtte ehttica! totle)' (sign ntnil be in legal lotelorhghtiryand rype)
n h) Is sign Lighted? yes (ntilrt nut ttate eltchial ndc) (ign nnst ln in legal ionelor lightitqg and gpe)
Fee: $100.00* - $75.00 refundable at time of final inspection and photo of compteted eign.'-\n extra 940.0O charge rvill be applied to aoy powered or lighted sign.
)rlorc: 'l'his drrcume nr
(no. 1027) at s'tr-$r".rcxburfi,.org for rcgularion informadon.
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ACTTON REQUIRED:
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Rec't Ackruwledged
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INSPECTED ITEMS CONFORM TO A
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/ENDOR #
/ENDOR NAME
Ind LINE NAME
\DDRESS
)ITY, STATE, ZIP
\f rs ec DATE
DH APPROVAL
CC APPROVAL
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RT,XBURG
Amer i ca\ Family CommunitY
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DESCRIPTION
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ACCT DESCRIPTION
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CLAIMANT OR HIS AGENT SIGN HERE
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- Transaction lsDetaio Page 1 of1
Transaction Detaits
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PZ SIGN DEPOSIT
Billing Information
Justin Stedman
, 84109
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i{L' L oL tsilnter (jl F,,rnter F,tirrt3t
to City of Rexburg.
_ _ Transaction Number: 16472552pTMastercard - XXXX-XXXX-XXXX-5434
Site Secured by - Starfield Technologies Inc.
Status: Refunded - Refunded
O Copvright ?003 - 201'2 Xpress Bilt pay LLC
1 s-225.AA
'iTotat Paid:
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IiI EXBURG
City of friexburg
35 Northlst East
Rexburg, lD 83440
208-35!t-3020ifrri Jililijt {:!r,rr,,r j,i ;tr
Bllling lnformation
Justin Stedman
. 84109
4Ci Col. Printer EA
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Transactlon taken by: marianna
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PaymontServiceProvldedByrywwxpressbillpay.com __
Copyright@Xpress Bill Pay2O12 -All Righis Reserved
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b Transaction detail for payment to City of Rexburg.Date: 06115J2012 - 10:14:43 AM
Transacfi on Number: 16734756PT
Mastercard - XXXX-XXXX-XXXX-543{
Status: Successful.
Description Reference #Amt perltem # ltems Total Amt
PZ PROCESSING FEE $25,00 3 s75.00
Notes: sign permlt 12 00286\r\nand 12 00285 and \r1n12
00284
PZ SIGN DEPOSIT $75.00 3 s225.O0
ELECTRICAL PERMIT $40.00 3 s120.00
Notes; sing permils 12 08116 and 12 0885 and V\n12 0084
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City of Rexburg
35 Northlst East
Rexburg, lD 83440
208-35S-3020
.ftt r;61. printer & I|*gwts@v:
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Transaction taken by: marianna
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Masterca rd - XXXX-XXXX.XXXX_S434
tatusl Successful
Lrescnpuon lReference#Amt per ltem l# ftems Total AmtPZ PROCESSING FEE $25.00 3 5;75.00N^otes: sign permit 12 OOZAOV\nano lt 002S5;nd V,6it00284
Z SIGN DEPOSIT $75.00 3 5225.0AELECTRICAL PERMIT $40.00 3 s120.OAlgqrtsggasq_flq-l? r0&F! and vrnlz oa84
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