HomeMy WebLinkAboutVein Center of Idaho 2536 N StokesberryIt
t
iJ i.a.../ I 1
Planning Division
LIMITED DT.TRATION SIGN PERMIT APPLICATIOl'9
Type of Review Requested
Limited Duration Sim Permit•. J
❑ 7 day ❑ 15 day ❑ 30 day 1160 day 0190 day. 2r'1'20 day. Expiration date's
Building permit number (caf1887-2%11 jor irrormation)
Applicant Information
Property owner's name: _ t'�`4r� e.�nE' -e� 16r,`an 'hone: .01O0
Property owner's address:- 6 ' / `V- a�i
Business owner's name: ( plt �69,,L ��_D � fe C. l"f Phone:�9
Business owner's address: �'/ 2 1a,�<l%pro r i kno SY le) Zip: a xgjgjc
Contact e-mai1: ! _� i'/J� l ,� c at A `„c f c e�,.,l<<r s �a !• ~ �D•�-� Fax:.�� - yam?
Subject Property Information ,
Business name:r". /`7�.+r;+tR•re`q It4!' iCtrt
Location/street address: -' 3 ell Zoning District:
Comments:
Limited Duration Sign Permit Information (if applicable)
Size of signn: Height (in feet): 3 Width (in feet): �. � � Location of sign: c r ee4o/r �t4!
Type of sign (e.k banner balloon, "T" frame, sandwich board, inflatable):
Name of person responsible for removal of sib _ C G 4r /r Phone: q4-/ JP .TQ o
Authorization
Business owner/authorized agent's printed name: S -do- Date:_
Business owner/authorized agent's signature: Date:
33 E. Broadway Avenue, Suite 102 • Meridian. Idaho 83642
Phone: (20-8) 884-5533 • Facsimile: (208) 888-6854 • Website: w�"r meridianciri.org
(rev. 03127P-013)
/-r-zb,3
AFFIDAVIT OF LEGAL LV'TEREST
STATE OF D)AHO) V
COUNTY OF ADA)
(name) (address)
.(city) (state)
being first duly sworn upon, oath, depose and say:
That I am the record owner of the property described on the attached, and I grant my
permission to:
F
(name)
(address) /`7P/,!a.+
to submit the accompanying application(s) pertaining to that property.
2. I agree to indemnify, defend and hold the City of Meridian and its employees harmless
from any claim or liability resulting from any dispute as to the statements contained
herein or as to the ownership of the property which is the subject. of the application.
�. I hereby grant permission to City of Meridian staff to enter the subject property for the
purpose of site inspections related to processing said application(s).
Dated this day of QlYI� 20 J
(Signature)
SUBSCRIBED AND SWORN to before me the day and year first above written.
G I L L 4XAJ�
AIL
���111111111!!//1/
v, '0 % (Notary Public for Idaho)
ptAR Y
�' �,•� = Residing at: 1
PU60G :rip\\ My Commission Expires: 3 c) 0100O
33 E. Broadway A -Venue, Suite 102 . Meridian, Idaho 83642
'hone: (208) 88455 33 tacsimle: (2108) 888-58,!4 • Vvebste: ; .me diancitr.or�
v»
� \ 4\
. y: : .
:
�
-
.
yf.
«\■�;§
r�
-
\ §' /
}�