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fri \Ti TOWN OF YAROUTH BUILDING DEPART ENT— —
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SIGN PERMIT APPLICATION
Date Application Accepted Permit No.340.5" -n 9
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Applicant Instructions
1) Applicant shall complete both sides of application.
2) One application form is required for each sign. Each sign will be assigned its own permit number.
3) Applicant shall attach separate 8 'h"x 11" sheets including the following diagrams:
A) Design, dimensions and colors of the proposed sign
B) Freestanding Signs:provide certified plan by a professional land surveyor that describes how the proposed
sign meets the zoning requirements included in Zoning Bylaw 303.5.6 or 303.5.4.2 (as applicable). A
stamped and sealed"as-built" will be required before the permit will be issued.
C) Attached Signs: show length of portion of building frontage that is occupied by applicant.
D) Temporary Signs: show location for sign
4) Sign permits are$40.00 each, payable at the time of application.
Address of proposed sign "11 Q- 2 r 1-4.- 7n.. u. Historic District
Name of Business for proposed sign �`'''-f' /4 t' (c-'o.A-, -- LA-
Name of Business owner ►Jo✓td 0-115
Mailing Address of Business owner 2- 1--`(N-2/SC 14i`-- P-t-- -4-a 1" -a,iNnviS �"1-- U t-Coo 1
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Business Owner Phone:Business 50 $9 4 - (-*4 `t 4 Home Cat - 77 tr- C 2-/- 2-oat
Name of Building Owner 0i0 61 0-6 c 1 I V- 1.-1_, C Phone 5-1D E" 3 c' t(--4 4 4h
Sign Builder 1 1 -. r_s Sign Materials
Sign Builder Address 050 R- 2'g Li (f'c--�.* -V's hone sV - -7-7?- a s.
Singly Occupied Building Business Center Internal Light External Light
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Freestanding Sign Si g
Size:
Attached Sign Size:
Temporary Sign Size:
Dates:
Please complete other side of Sign Permit Application
All Permits are subject to the approval of the Sign Inspector
I hereby agree to conform to the provisions of Town of Yarmouth Zoning By-law Section 303 governing sign
construction and installation. I further agree that this sign will not be altered,added to or changed in any way unless
a new permit has been issued. Sign Permits are not valid until the Building Commissioner issues Use and
Occupancy Permits (where applicable). Freestanding sign permits are not valid until the "as-built" from a
professional land surveyor has been received.
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Signature of Applicant: Date
Property Owner Authorization: I hereby authorize the applicant to act on my behalf in all matters related to this
sign application. (Signature) ✓� _ Date g- ( 9 —2_C) I
Approved by: Date 9--4713-7r
With the following conditions:
Vr-C3e /Ye#/.
I have read and understood the conditions of this Sign Permit listed above: _
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