HomeMy WebLinkAboutYogurtz 1560 N Locust GrovePlanning Division
LEY=D DURATION SIGN PEPM APPLICATION
Type of Review Requested
Limited Duration Sim Permit-
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Eli ? day - l 15 day ❑
30 day � ay C 40 day
11120 day.n Expiration dace;
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Building permitnumber(caI1887-_7?11for
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Applicant Information
Property owner's name:
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Phone:
Property owner's address:
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Zip: P36yz
Business owner's name.
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Phone: p
Business owner's address"
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Zip: ,,F- 36 i�
Contact e-mail: VD
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Fax 98a
Business
Business name:K 06000-f C--
Location/street addresS7
--Location/streetaddress: ��6�- r-,�r Zoning District:
Comments:
Limited Duration Sim Permit Information Of aunlicable, .. /
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Size of sign: Height (in feet): L , -Fid Width (in f et): I VC Location of
Type of sign (e.g auner balloon, "T" frame, sandwich boardtinflatpable):
Nameofpersonnsponszbleforrmovalofsign:
Business owner/authorized agent's printed name:
Business owner/authorized agent's signature:
33 E Broadway Avenue; Suite 102 • Meridian. Idaho. 83642
Phone: (248) 884-5533 • Facsimile: (308) 888-6854 • Vvebsue: w .meddianchy.org
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AFFID_AN71L OF LEGAL MEREST
STATE OF IDAHO )
COUTNT' of ADA )
�AV�D L i4ou,�A►.l kkoU W' NIr��N Sr
(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:
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(name) (address). PUtDtANt ZD
to submit the accompanying application(s) pertain�v to that property.
2. I agree to indemnify, defend and hold the City of Mendian 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.
3. 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 Ila day of SQT .20 -
(Signature) 20 ►-
(Signature)
SUBSCRIBED AND SWORN to before me the day and year first above written.
NotaryPublic for Idaho
Residing at: J30 I SG, I GL -h o
t: NdTARY i My Commission Expires: D 1 12A 12015
PUBLIC ?
�13 E Bmaduav Avenue; Suite 102 • Meridian, Idaho 83642
SM -5533 • Fac_em+fle: (208) 88M854 • Website: r tvn�.seridiancCY.ors
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