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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 .-,""_ - t/\ iJ[ST,qOY Fixed Signage i?lr\ site Address.citv .,r Telephone:Mobile: City/State/Zip: K€xbu r,\ tD 8 r,"(L/O .-J Contractor Information Contractor's Name: Contractor's Address: Contractor's Phone:City/State/Zip: +rA€*i*e{ 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): ,l{i;{v,i ,-8?,3!y _ p0 AJr'r gApp|icanF.fpffi6qation Owner,5g6ronrco M If A[Y-A$mu- Zc,8- 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. I. 2. 3. 4. 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: $40.00 2/t/tr INSPBCTION TICK} Itt tr BHg. O Plumb' fl Ebcr. O Mcch. O Fire I nspction Request: Rec'd_p}LLI o.r. tO Z\ \L Req. By;,''.*tc Prolecti\i \ Address ? Inspection Type Day ffime Req. \r \1L\Y-\Z t\r I \-t lf.-' Phone No. N\ INSPECTED ITEMS CONFORM TO APPROVED DWGS D DISAPPROVED NNOTAPPLICABLE f]Y f]N fl N/A DFINAL []DrD NOTTNSPECT INSPECTOR'S ACTION p[nernoveo /\' nc.o.(FINAL) ACTION REQUIRED: Rec't Acknowledged lvtrat. - o|tcc Copy F.FrR.Cqr3 rt|oil - Joo Cogt Pil-ln*rcbl@r - '\,r CLAIM FORM VENDOR # VENDOR NAME 2nd LINE NAME ADDRESS CITY, STATE, ZIP -Dih,JoRrE DH APPROVAL It b l'2 l12ct l-1- j 2, r{ " fe ritr- . Ji()cl,;c..r, ,a D CC APPROVAL 0 CIl'Y OF REXSTIRG Am e ri c a\ t' arn i ly C o rn mun i ty 1];-,'rwi.t u\ t,'L d0 ( t{ g' , 1I' la-,I" t, r.- L r b r,a r-r -' tr,t't'5, ',t( f'dq, I t i.'lr(-L 0-,Q o.", " /". ,'oi Lutt'k oit{r: r'.i i.l"L- tl,, .$- ' i)i..o-n l ty;,i.-,- w blzLo l t7 nn?- Qt t,r '/( lct-tr*- ,A''l t l-Ur n ,-:, cLAIMAMb#IS AGENT SIGN ffine ol \ ,) .; <r.6', q- ,. 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:$s_qryj9_9_fo_yj9"99*By_yyf_:rpllgtpiupay.com Copyright @ Xpless Bill pay 2012 - All Rights Reserved I hPR o 3 2012 https ://www.xpressbillpay.com./common/payment Drocess.Dho 4/2,t)N) , "01:rr Bill Pay - Transactionffails Navigation Home Billing Tools Receipt Payment View Xpress Cart eBill History My Till Report Admin Tools Reports Download Daily Batch Manage My Profile Technical Support Technical Support ilffi Billing Information VALERIE VAIL ,83440 I t{ J Transaction Notes: refund for Madison Library Sign permit # 1200146I )i Transaction taken by: marianna {.s$Ss*; Site Secured by - Stariield Technologies Inc.Security I Contact Us I Privacy Policy (S Ccpyri0hl2003 - 20'12 Xpress Bill Pay LLC 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