2001-404 Champion Sign Craft i CO
I Fee Paid: (Q
TOWN OF QLTEENSBURY
•" 742 Bay Road, Queensbury, NY 12804 Approved By:
(518) 761-8256 Permit #: 24 ,/- 1/0
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SIGN PERMIT APPLICATION F- \.� t1
THE FOLLOWING INFORMATION IS REQUIRED: ,JUN 1 3 2001
1. Detailed drawing or photo of sign. i"�•j°b'NO "" + C. ODE}
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2. Plot plan of location of sign. -,?�E�L'�' �' " �
3. Written consent of the owner of the building or land.
OWNER OF PROPERTY 'f2 ;-7 /34 ,P ,
ADDRESS '/ � u- 6-6 �� TEL. 3 -6715
NAME OF APPLICANT Aaii) 7,.P,4f 1 4
ADDRESS 0;70 iV 7 (P TEL. 7' Z". d/
BUSINESS NAME IF DIFFERENT: C/JA '2✓.,/e,11' c7 - C,
TYPE AND LOCATION
Check What Applies: Existing __ Permanent 'd, Projecting Sign __
Temporary Non-conforming Existing __
Free-Standing _ -' Wall —_ New __
Location: Tax Map Number '7i _ - r7 - a
Address — --- `� / �) Ar'1/ - /4 /_.� e j l
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Proposed Setbacks from Property Line (front) (sid G
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If sign is to be illuminated, please check appropriate box: ego' I
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Internal ( ) , External (V1, Incadescent ( ) , Neon ( ) , Other ( )
Size of Sign: Width ft. Length 6 _ ft.
Total Square Footage: ' 3S2 1-
Sign Copy: 5g"1 i%Q i/61/7"-
Color and Material T B Used: gLz.i+s/8U/2-‘u'rWV `N/C ;(440o- FerA4)
Signature: .(--/ `� ,,-0,p---_,
Cir le One: plica , owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON M ROPERTY OR BUILDING.
Signature of Property Owner: %: 4% -L- 1,, LI 7 o-ee.� G�
ORIGINAL-Office Copy COPY-Applicant
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