2004-241 NYC Italian Ices TEMPORARY SIGN PERMITAPPLICATION
TOWN OF QIUEENSBURY PERMIT NUMBER: joc)
Dept. of Community Development
742 Bay Road Fee Paid:
Queensbury,New York 12804 Deposit Paid: 0
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Important Notice: 1a27j4
Temporary Sign Permits are issued for a period of 12 calendar days not to exceed 60 calendar days per year
per applicant. Exception-political signs(see attached Local Law).
/ removal �i DATE: placement of sign: J / 7 / y� DATE: removal of sign: /11�' / �
Applicant Name(individual or business name): /" `
Mailing Address: Telephone No.
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Exact Location/Placement of Sign: r
Tax Map Number: Section , Block , Lot
Type of Sign: (only one [11 sign allowed per permit-exception)
Political Signs ONLY(to be placed 60 days prior to event)
Sign Copy for Political Sign:
Wall Sign (not to exceed 32 square feet) Sign Copy:
Freestanding Sign(not to exceed 16 square feet) ign Copy:
SIZE OF SIGN: Z- x = 30
sq. ft.
signature of applicant signatur r owner if
different from applicant name
Failure to remove sign at expiration may result in forfeiture of deposit as per the
Code of the Town of Queensbury, Section 140, Subsection 140-4 (Local Law No. 11, 1993).
Send Refund-deposit to:
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