HomeMy WebLinkAboutCheck N Go 450 S MeridianECEIVE
AUG 2 5 2015
Planning Division
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Lri4IITED DLTR=,SIGN SIGN PERMIT APPLICATIOlti
Type of Review Requested
Limited Duration Sim Permit
i1 7 day ❑ 1- day Crj0 day ❑ 60 day ❑ 90 day ❑ 120 day."Expiration dare: 4 aFJ I
Building permit number (ca11887-211forbVormwion) Pj[1 -134e
Applicant Information ////�
Property owner's name: D rdo Y1 D 1(L, q aCl f ),t Phone: 3>V_ 1/(2t
Property owner's address: ;P30 S 5 `I'n 51- ✓k6e x M Zip: 'i 70.E
Business owner's name: CA 4 UL n6!) Phone: 354
Business owner's address: `-lS0 SWW!' i A l LL
Contact e-mail_:
Information
Business name: 1 rX
Location/street address: t1-506OWriAian.- 35 Zoning
Limited Duration Sign Permit Information (if applicable)
Size of sign: Height on feet): 3 ' Width (in feezo: is t Location of sign: 4a 2c& qe.s& PU 5 dY W,,L .—
Type of sign (e.g. banner, balloon, "T" frame, sandwich board, inil�atable): CC n M !L
wi
Name of person responsible for removal of sign: l i I ( !'t S `\ L (I Phone: -?f%�' - 9V i -3S U�r
Autborization -
Business owner/authorized agent's printed name: d Date:
Business owner/authorized agent's signature: , Date:
33 E. Broadway Avenue. Suite 1C2 • Meridian, Idaho 83642
Phone: (2C8) 884-5533 • Facsunile: (208) 888-6854 • Website: w, .w.meridiancity.or?
(Rev. 03/77.2013) ' . .
AFFIDAVIT OF LEGAL INTEREST
STATE OF IDAHO )
COUNTY OF ADA )
(state)
being first duly sworn upon, oath, depose and say:
1. That I am the record owner of the property described on the attached, and I grant my
permission to:
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.
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).
Date&this 2S"` day of /Qua-u�- -120 1-5
( guature) .
SUBSCRIBED AND SWORN to before me the day and year fust above written.
Ctbilfp}i41tU 4f1. / %�"
Y,
`XwP,l3 3?. IV 'P
(Motarypxfolic for Idahoj)
v OI. qR y Residing
My Commission Expires: 0 .--149 J ? /
lrr df PUBO .t? 4-
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-e��is= 33 E. Broadway Avenue, Suite 102 . Meridian,idaho 83642
Phone: (208) 887-2211 • Facsimile: (208) 887-1297 • Website: www.meridiancity.org
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