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I I --------.- SIGN PERMIT WORKSHEET ~ APPLICA~rrON DATE ADDRESS: ~g-D~::, N 11 rl(...i\.Av c ____ DESCRIPTION OF WORK: ~+C1./tL, nJ :,.L) all -P, ~C' g<- O".2,;;;l. (0 -;), ~Dooo- LOT I ZONING: l1AP I PARCEL # 00 b () '"' _ -0 0 ~.-o ," --.. OWNERS NAME: E~:\~ H~f''-{.ri. PHONE I C_l_- ~~~~;SS: ~~ ;t.~ {t' '2/- . v<~. = STATE: FI ZIP CODE: 3> 3 6"1.( ~ OCCUPANCY TYPE: TYPE OF CONS!I'RUCTIO'N: \---J ew SIGN VALUE: $ ~5D, 0 D . .----. '. .PROPOSED USE OF THE BUILpING/SPACE $\..A'-\-o ~G-+c~ \: W'& +-- ~(J: _ PROPERTY FRONTAGE: FEET: SQUARE FEET OF FACE OF BUILDING .3 'f! D IGROUND MOUNTED SIGNSI PRIMARY SIGN: PROPERTY FRONTAGE SIDE SETBACK REQ. ALLOWABLE SQ FT ------------ --------~-------- ----------------- SECONDARY SIGN: MAXIMUM HEIGHT OF GROUND ~OUNTED SIGN: PRIMARY GROUND SIGN ~HIS SITE ___FT X ___FT = TOT~L SQ FT LESS THANi SO' 50' - 99 f. 100' - 19j;)' 200' - 29~' JOO' + 10 FEET 10 FEET 20 FEET 50 FEET 50 FEET --------------- 24 SQ FT 32 SQ FT 64 SQ FT 72 SQ FT 96 SQ FT 24 SQ FT SECONDARY GROUND MOUNT SIGN er X FT = .TOTAL SQ FT - - --- 'WALL MOUNTED SIGNSI SINGLE OCCUPANCY: PRIMARY SIGN: = 2' SIGNS NOt TO .EXCEED 20% OF THE ". OR 200 SQ fT. SECONDARY WALL SIGN NOT TO EXCEED 50 SQ FT FACE OF THE BUILDING , - MULTIPLE OCCUPANCY: 2 SIGNS NOT TO EXCEED 10% OF THE SECONDARY srGN - 24 SQ FT PRIMARY WALL MOUNT SIGN FT X FT = TOTAL --- - IS THE SIGN 'ILLUMINATED? ~ES: TYPE OF ILLUMINATION: t' CONTRACTOR: Luroc '& (i) t. /?r" ~DDRESS : dill AAI. !:::uA 1 /, &::l.6vt- CITY: -r -^ ......._ \ \PPLICANT SIGNATURE: FACE OF THE BUILDING OR 100 SQ FT SECONDARY WALL MOUNT SIGN l.Q2~ X, '7 "FT = ~.~2. TOTAL NO: X ELECTRICAL PERMIT? Y: N: - LOCAL LIe. # -= F-I ....3> 3 ~I 8.., STATE: ZIP: IISCELLANEOUS REQUIREMENTS: LANNING APPROVAL: BUILDING APPROVAL: