2003-964 Olde Post Grille loTOWN OF QUEENSBURY Fee Paid:
w 742 Bay Road, Queensbury, NY 12804 Approved By:
518) 761-8256 Permit #: 3
SIGN PER141T APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED: SScF_N ED
1. Detailed drawing or photo of sign. %jc�f 2003
- 2. Plot plan of location of sign.
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3. Written consent of the owner of the building or lanq.,vol o 0UEV_,N813URy
(--OWNER OF PROPERTY
ADDRESS k one.yet �oq //YL,7 z7TEL. 66,�'-5176
06 NAME OF APPLICANT Ile-
ADDRESS 1300 Sue Zak G&eVe TEL.
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BUSINESS NAME IF DIFFERENT:
TYPE AND LOCATION
Check What Applies: Existing V/ Permanent LOCATION
Sign
Temporary _ Non-conforming Existing
Free-Standing Wall New
Location: Tax Map NumberC d =1
Address
Proposed Setbacks from Property Line (front) (side)
If sign is to be illuminated, plea
se heck appropriate box:
Internal External Incadescent Neon Other
Size of Sign: Width ft. Length ft.
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Total Square Footage: Z"� 3--(, FT-
Sign Copy: +L' CLOG' NZ
Color and Material To Be Used: -COIV4 LV�'- Pqcvt- '*-/ 6,44 l� f
�..Signature: —------
-
Clylclore:' pplicant owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
�_Signature of Property Owner:
ORIGINAL-Office Copy COPY-Applicant)
03,
Imp-
MAILING: SHOWROOM:
P.O. Box 332 • Glens Falls,NY 12801 52 Main Street • Queensbury,NY 12804
ph. 518-792-4009 fx. 518-792-4476
g.l�y.1 9 2003
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