HomeMy WebLinkAboutALL DOCS - 12-00146 - 73 N Center St - Madison Library District - Signt-
Sign Permit Applicolion CtrTY OF
City of Rexburg
Phone; 208.359.3020
Fox: 208.359.3022
Completro,lffi
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iJ[ST,qOY Fixed Signage
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site Address.citv .,r
Telephone:Mobile:
City/State/Zip: K€xbu r,\ tD 8 r,"(L/O
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Contractor Information
Contractor's Name:
Contractor's Address:
Contractor's Phone:City/State/Zip:
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Electrical/specialty contractor Information (For powered or righted signs)Contractor Information
Contractor's Name:
Contractor's Address:
Contractor's Phone:City/State/Zip:
Mobile:Contractor's Signature:Date:Sign lnformation
Sign Area sq. ft:
Sign Description:Sign Height (from ground):
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_ p0 AJr'r gApp|icanF.fpffi6qation
Owner,5g6ronrco M If A[Y-A$mu-
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For a Sr'sn Permit it it rrndrtoru
2 Sets of elevation drawings of a sign & (plot ptots if oppticable)Drawn to scale with dimensions and complete construction materials-Footings if applicable
Engineer stamped if required
FREE.ST+NI}ING S]GN WALL STGNSiT"LOT PLAN TO SCALE SHOWING 3 A) SQ. FOOTAGE OF WALL {s/C/V ON)tl*feulLolNc LocATtoN
IB) LOTSIZE
vsnrrvrr U B]EXISTINGSIGNS&AREA
[d{,il;;r LocAroN tr c) NEW srGN & AREA
6F.r"l;,u*o 'u,n FR.M pRopERlv |rN.Es i 3i :'i3l':,:ff;:|r:?#lH eet stote electricotcode)
P*TI,--_O LOT ENTRANCES (sign must be in legat zone for tighting and type)fi,l,Flprsraruce oF stGN FROM RIGHT OF WAy,td) ExlsrrNG stcNs LocATtoN & AREA
tr H) ls slGN LIGHTED? YES (must meet state electricol code) (sign must be in legal zone for tighting and type)Fee: $100* - $75.00 refundabre at time of final inspection and photo of compreted sign.*An extra S40.OO charge will be applied to any powered or lighted sign.
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Signature of Applica nt:oate: f *3 ^17.
Note: This document is for application proposes only (the legal sign permit form must be signed by city officials before sign is approved)see sign ordinance g0g at www.rexbur*.orq for regurationlnformation.
For Office Use Only:
Receipt codes: (Regular) t I pz= $25.00 [ ] pzsD= $75.00 (For Elecrrical Add) I I ELp: $40.00 2/t/tr
INSPBCTION TICK}
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I nspction Request: Rec'd_p}LLI o.r. tO Z\ \L
Req. By;,''.*tc
Prolecti\i \
Address ?
Inspection Type
Day ffime Req.
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Phone No.
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INSPECTED ITEMS CONFORM TO APPROVED DWGS
D DISAPPROVED
NNOTAPPLICABLE
f]Y f]N fl N/A
DFINAL
[]DrD NOTTNSPECT
INSPECTOR'S ACTION
p[nernoveo
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nc.o.(FINAL)
ACTION REQUIRED:
Rec't Acknowledged
lvtrat. - o|tcc Copy
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CLAIM FORM
VENDOR #
VENDOR NAME
2nd LINE NAME
ADDRESS
CITY, STATE, ZIP
-Dih,JoRrE
DH APPROVAL
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Ji()cl,;c..r, ,a D CC APPROVAL
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CIl'Y OF
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Am e ri c a\ t' arn i ly C o rn mun i ty
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cLAIMAMb#IS AGENT SIGN ffine
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,. Il:"tt Bill Pav - Pavment tf,ttttnu Page 1 of I
i i r i r,l City of Rexburg
35 Northlst East
Rexburg, lD 83440
208-359-3020
R]IXNL]RT]
l Transaction detail for payment to City of Rexburq.Date:0410312012 - 10:15:2S AMi
Description Reference # lAmt per ltem # ltems Total Amt
PZ PROCESSTNG FEE I
Notes:MADISON LIBRARY
$2qqo I I s2s.a0
PZ SIGN DEPOSIT $75.00 1 s7s.aa
Transaction Number: 14843362pT
Visa - XXXX-XXXX-XXXX-6S20
Status: Successfu{
Billing Information
VALERIE VAIL
,83440
lrotat Paid: _J,, __ _s:ga.gg _1
Transaction taken by: shelliet
iI:mt ri$teee.l
Jl,v-r:$s_qryj9_9_fo_yj9"99*By_yyf_:rpllgtpiupay.com
Copyright @ Xpless Bill pay 2012 - All Rights Reserved
I
hPR o 3 2012
https ://www.xpressbillpay.com./common/payment Drocess.Dho 4/2,t)N)
, "01:rr
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Billing Information
VALERIE VAIL
,83440
I
t{
J Transaction Notes: refund for Madison Library Sign permit # 1200146I
)i
Transaction taken by: marianna
{.s$Ss*;
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Page I ofl
l Transaction detail for payment to City of Rexbur
IPZ SIGN DEPOSIT
+r: col. nrint*r J $ pnnt*, rr,-.t & j
Date: 06/26/2012 .11:43:25 AM
Transaction Num ber: I 588981 7PT
Visa - XXXX.XXXX-XXXX6520
Status: Refunded - Refunded
https://www.xpressbillpay.com/common/trans_details.php?trans id:MTc4MzcwMTl%3D 612612012
Receipt Number:l&0104 :
35 North 1st East / Rexburg tD. 834td
Phone (208) 359-3020 / Fax (208) g1g_g022
RPRRXBl032 SignDeposit
RPRRXBl032 Sign permit
$100.00