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MMR Department
SI-f3N P E RAUT APPLICATION
TION
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Property owner's
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Proter�r oNimer's address: ,,� _ �l �VZC)Z) Z41b a
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Business oi� ner's irime: -, PhOne:
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Business o`vner s address: _ P
Sign contractor:
Sign contractor address:
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Phone:
Zip' X,�
Primary contact is: ❑ Property owner ❑ Business ovmer Sign contractor ❑ Other
Contacte-mail: fj t C Fax:
Subject Property Informadon
Business name: Merl
Location/street address: �' ff� ��' Zoning district:
Range of addresses (if PSP) :
Legal Description: Lot Block Subdivision
Is there an existin Planned Sign Program for this property? Yes X$� ❑ Not required P)l
Commen
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Temporary Sign ]Permit Information (if applicable)
Size of sign: Height (in feet) Width (in feet)
Type of sign (e.g. banner, balloon, "T" frame, sandwich board, inflatable):
Name of person responsible for removal of sign: Phone:
Authorization n_ d
Business owner/authorized agent's printed name:
Business o-%timer/authorized agent's signature:
Date:
61
Date: A�
STAFF USE ONLY: Date til File num (s): 'rr7" Sig1Z Permit Fee:
Planning Dept. apprm.-a1: Date. _
Building Dept. approval: Date:
660 E. Waterto«er Lane; Suite 202 Q NVlen'dian, Idaho 83642
Dl:one: (208) 884-5533 o Facsimile: (208) 888-6678 o Website: