From: <Saved by Windows Internet Explorer 8>
Subject: sign permit
Date: Thu, 21 Jan 2010 15:46:23 -0500
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Oneida</o:LastAuthor>  <o:Revision>2</o:Revision>  =
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<TABLE=20
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  <TR>
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        <TBODY>
        <TR>
          <TD vAlign=3Dtop colSpan=3D2 noWrap>
            <H1><FONT size=3D3>APPLICATION FOR SIGN PERMIT &amp;<SPAN=20
            style=3D"mso-spacerun: yes"></FONT><FONT=20
            =
size=3D4>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
            </SPAN></FONT></H1>
            <P class=3DMsoNormal><FONT size=3D3><B>CERTIFICATE OF=20
            COMPLIANCE</B></FONT><FONT=20
size=3D2><B><O:P></O:P></B></FONT></P></TD></TR>
        <TR>
          <TD><B>Zone:</B>__________
            <P class=3DMsoNormal><O:P></O:P></P>
            <P class=3DMsoNormal><B>Fee:</B>___________</P>
            <P class=3DMsoNormal><O:P></O:P></P></TD>
          <TD>
            <DIV align=3Dcenter>
            <CENTER>
            <TABLE border=3D0 cellSpacing=3D0 cellPadding=3D0>
              <TBODY>
              <TR>
                <TD colSpan=3D2 =
align=3Dmiddle><STRONG>**FEE**</STRONG></TD></TR>
              <TR>
                <TD noWrap>R1, 2, 3, R-P, MMD-P</TD>
                <TD width=3D"10%">&nbsp;</TD>
                <TD>$25.00</TD></TR>
              <TR>
                <TD>A</TD>
                <TD>&nbsp;</TD>
                <TD>$45.00</TD></TR>
              <TR>
                <TD>C, M-I, B</TD>
                <TD>&nbsp;</TD>
                =
<TD>$75.00</TD></TR></TBODY></TABLE></CENTER></DIV></TD></TR>
        <TR>
          <TD colSpan=3D2>******************************
            <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt">Code =
Enforcement=20
            Office<O:P></O:P></SPAN></P>
            <P class=3DMsoNormal><B><SPAN=20
            style=3D"FONT-SIZE: 10pt">ATTN:</SPAN><SPAN=20
            style=3D"FONT-SIZE: 10pt"></B> Patrick =
Baron<O:P></O:P></SPAN></P>
            <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt">Municipal=20
            Building<O:P></O:P></SPAN></P>
            <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt">109 N. =
Main=20
            Street<O:P></O:P></SPAN></P>
            <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt">PO Box=20
            550<O:P></O:P></SPAN></P>
            <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt">Oneida, =
NY=20
            =
13421-0550<O:P></O:P></SPAN></P></TD></TR></TBODY></TABLE></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 0.5pt solid; BORDER-LEFT: =
windowtext 0.5pt solid; PADDING-BOTTOM: 0in; PADDING-LEFT: 5.4pt; WIDTH: =
226.25pt; PADDING-RIGHT: 5.4pt; HEIGHT: 217pt; BORDER-TOP: windowtext =
0.5pt solid; BORDER-RIGHT: windowtext 0.5pt solid; PADDING-TOP: 0in"=20
    vAlign=3Dtop width=3D"60%">
      <H1=20
      style=3D"TEXT-ALIGN: center; mso-element: frame; =
mso-element-frame-width: 243.0pt; mso-element-frame-height: 2.5in; =
mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; =
mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: =
margin; mso-element-top: -8.95pt"=20
      align=3Dcenter><FONT size=3D5><SPAN=20
      style=3D"FONT-SIZE: 11pt; mso-bidi-font-size: 10.0pt"></FONT><FONT =

      size=3D4>OFFICIAL USE ONLY</FONT><FONT size=3D5><O:P></FONT><FONT=20
      size=3D1></O:P></FONT></H1>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>APPLICATION #=20
      __________________</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>PERMIT #=20
      ________________________</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>DATE REFERRED =
TO</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>SIGN REVIEW BOARD=20
      ________________</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>RECOMMENDATION =
OF</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>SIGN REVIEW BOARD=20
      ________________</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>ACTION TAKEN=20
      __________________</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>DATE OF=20
      ACTION_______________</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal align=3Dleft><FONT size=3D1>SIGNATURE =
OF</FONT></P>
      <P=20
      style=3D"mso-element: frame; mso-element-frame-width: 243.0pt; =
mso-element-frame-height: 2.5in; mso-element-frame-hspace: 9.0pt; =
mso-element-wrap: around; mso-element-anchor-vertical: paragraph; =
mso-element-anchor-horizontal: margin; mso-element-top: -8.95pt"=20
      class=3DMsoNormal><FONT size=3D1>BLDG.=20
      =
INSPECTOR_______________</FONT></P></SPAN></TD></TR></TBODY></TABLE></DIV=
>
<H3><SPAN style=3D"FONT-SIZE: 11pt; mso-bidi-font-size: 10.0pt">TO BE =
COMPLETED BY=20
APPLICANT</SPAN><SPAN style=3D"FONT-SIZE: 10pt"><O:P></O:P></SPAN></H3>
<P class=3DMsoNormal><B><SPAN style=3D"FONT-SIZE: 10pt">1. <SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN></B><B><U>APPLICANT INFORMATION</U></B><B></SPAN><SPAN=20
style=3D"FONT-SIZE: 10pt"><O:P></O:P></SPAN></B></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>A.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Applicant=20
Name_____________________________________<SPAN style=3D"mso-spacerun: =
yes">&nbsp;=20
</SPAN>Tel# ______________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>B.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Applicant=20
Address________________________________________________________<O:P></O:P=
></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>C.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Property Owner =
if other=20
than =
applicant________________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>D.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Sign=20
Company/Representative=20
_______________________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>E.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Sign=20
Owner/Lessee________________________________________________________<O:P>=
</O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><B><SPAN style=3D"FONT-SIZE: 10pt">2.<SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;=20
</SPAN></B><B><U>SIGN INFORMATION<O:P></O:P></U></B><B></SPAN></B></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>A.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Street =
Address/Location=20
of Proposed Sign =
______________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>B.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Zoning District =

________________________________________________________<O:P></P>
<P class=3DMsoNormal></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>C.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Lot =
Dimensions<SPAN=20
style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp; =
</SPAN>Width_________________<SPAN=20
style=3D"mso-spacerun: yes">&nbsp; </SPAN>Depth __________________<SPAN=20
style=3D"mso-spacerun: yes">&nbsp; </SPAN>Area=20
_________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal =
align=3Dcenter><EM><STRONG><U>NOTE</U></STRONG></EM></P>
<P class=3DMsoNormal align=3Dcenter><EM><STRONG>If applying for window =
sign,=20
indicate size of window(s). Permenent window signs will not exceed 15% =
of the=20
window on which it is painted.</STRONG></EM></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>D.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN><U>Placement of =
Sign on=20
Premises:<O:P></O:P></SPAN></U></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN>Distance from lot=20
line____________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN>Distance from side lot lines=20
_______________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp; =
</SPAN>Distance=20
from any bldg. on lot =
_____________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>E.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Proximity to =
adjoining=20
uses:<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp; =
</SPAN>Distance=20
from closest building ____________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp; =
</SPAN>Distance=20
from closest sign ________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal>&nbsp;</P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>F.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Placement of=20
sign<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><B>**Important </SPAN><SPAN=20
style=3D"FONT-FAMILY: 'Monotype Sorts'; FONT-SIZE: 10pt; =
mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times =
New Roman'; mso-char-type: symbol; mso-symbol-font-family: 'Monotype =
Sorts'"><SPAN=20
style=3D"mso-char-type: symbol; mso-symbol-font-family: 'Monotype =
Sorts'"></SPAN></SPAN><SPAN=20
style=3D"FONT-SIZE: 10pt"></SPAN><SPAN style=3D"FONT-SIZE: =
10pt"></B>Length of=20
building face=20
_____________________________<O:P></O:P>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN=20
style=3D"mso-spacerun: =
yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;=20
</SPAN><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN>Building Height (approximate, *see definition)=20
____________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN>Percent of Building/Roof area covered by sign=20
___________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>G.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Sign =
Classification<SPAN=20
style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN>Principal______________<SPAN style=3D"mso-spacerun: yes">&nbsp;=20
</SPAN>Accessory _______________<SPAN style=3D"mso-spacerun: =
yes">&nbsp;&nbsp;=20
</SPAN>Other _________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>H.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Type of=20
Sign<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN>Freestanding _____ Wall _____ Roof _____<SPAN=20
style=3D"mso-spacerun: yes">&nbsp; </SPAN>Projecting _____ Window =
_____<SPAN=20
style=3D"mso-spacerun: yes">&nbsp; </SPAN>Double-Faced=20
______<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>I.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Sign=20
Size<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp; =
</SPAN>Height from=20
ground level to bottom of sign__________<SPAN style=3D"mso-spacerun: =
yes">&nbsp;=20
</SPAN>Length_________<SPAN style=3D"mso-spacerun: yes">&nbsp;=20
</SPAN>Width___________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp; </SPAN><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;=20
</SPAN>Depth _______________<SPAN style=3D"mso-spacerun: yes">&nbsp; =
</SPAN>Total=20
Sign Area _____________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>J.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Sign=20
Description<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-spacerun: =
yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN>Materials_________________________________________________________=
_________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;=20
</SPAN>Illumination:<SPAN style=3D"mso-spacerun: yes">&nbsp;=20
</SPAN>Interior__________<SPAN style=3D"mso-spacerun: yes">&nbsp;=20
</SPAN>Exterior___________<SPAN style=3D"mso-spacerun: yes">&nbsp;=20
</SPAN>Type______________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;=20
</SPAN>Structure/Attachment of Sign=20
__________________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp; =
</SPAN>Business Hours=20
of Operation<SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp; =
</SPAN>AM=20
________________<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>to<SPAN=20
style=3D"mso-spacerun: yes">&nbsp; </SPAN>PM=20
__________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp; =
</SPAN>Color/Lettering=20
____________________________________________________<O:P></O:P></SPAN></P=
>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;=20
</SPAN>_______________________________________________________________<O:=
P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp; =
</SPAN>Relationship to=20
Building/Land =
__________________________________________<O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</SPAN>K.<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Describe and =
identify any=20
proposed future signs on these premises ____________________<BR=20
style=3D"mso-special-character: line-break"></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: 10pt"><SPAN=20
style=3D"mso-spacerun: yes">&nbsp;</SPAN><SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;=20
</SPAN><SPAN style=3D"mso-spacerun: yes">&nbsp;&nbsp;&nbsp;=20
</SPAN>___________________________________________________________<O:P></=
O:P></SPAN></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<P class=3DMsoNormal><B><SPAN style=3D"FONT-SIZE: 10pt">3.<SPAN=20
style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;=20
</SPAN>SIGN ILLUSTRATION:</SPAN><SPAN=20
style=3D"FONT-SIZE: 10pt"><O:P></O:P></SPAN></B></P>
<P style=3D"MARGIN-LEFT: 0.5in" class=3DMsoNormal><SPAN =
style=3D"FONT-SIZE: 10pt">In=20
the space below, draw to scale your proposed sign, illustrating the =
information=20
you have given in =93I=94 and =93J=94 above.<SPAN style=3D"mso-spacerun: =
yes">&nbsp;=20
</SPAN><B>**Note:<SPAN style=3D"mso-spacerun: yes">&nbsp; </SPAN>Be sure =
to=20
indicate color &amp; size of letters and colors of any sign =
background.<SPAN=20
style=3D"mso-spacerun: yes">&nbsp; </SPAN>Also describe materials of =
background,=20
letters, illumination &amp; its location and method of sign =
attachment.<SPAN=20
style=3D"mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
</SPAN><O:P></O:P></SPAN></B></P>
<P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 9.45pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none; mso-border-alt: solid windowtext .5pt; =
mso-padding-alt: 0in 5.4pt 0in 5.4pt"=20
border=3D1 cellSpacing=3D0 borderColorLight=3D#990000 =
borderColorDark=3D#333333=20
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 0.5pt solid; BORDER-LEFT: =
windowtext 0.5pt solid; PADDING-BOTTOM: 0in; PADDING-LEFT: 5.4pt; WIDTH: =
513pt; PADDING-RIGHT: 5.4pt; HEIGHT: 262.5pt; BORDER-TOP: windowtext =
0.5pt solid; BORDER-RIGHT: windowtext 0.5pt solid; PADDING-TOP: 0in"=20
    vAlign=3Dtop width=3D684><SPAN=20
style=3D"FONT-SIZE: 10pt">&nbsp;<O:P></O:P></SPAN>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P class=3DMsoNormal><SPAN style=3D"FONT-SIZE: =
10pt"><O:P></O:P></SPAN></P>
      <P style=3D"tab-stops: 81.0pt" class=3DMsoNormal><SPAN=20
      style=3D"FONT-SIZE: 10pt"><SPAN=20
      style=3D"mso-tab-count: =
1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
      </SPAN><O:P></O:P></SPAN></P></TD></TR></TBODY></TABLE>
<P class=3DMsoNormal><SPAN=20
style=3D"FONT-SIZE: 10pt"><O:P></O:P></SPAN></P></SPAN></BODY></HTML>

