2002-826 Charter One TOWN OF QUEENSBURY Fee .Paid:
742 Bay Road, Queensbury, NY 12804 Approved By:
(518) 761-8256 Permit #: 2002--
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED: RECOVED
OCT 0 1 2002
1. Detailed drawing or photo of sign.
2. Plot plan of location of sign. TOIN'iq OF CDUEENSBUIn-
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3. Written cont of the owner of the, building or land.
W bi 1 N 3 RE-RZY- IL 3T�T
ADDRESS 2 7V) Lk-7 'J1ANQ f_y,)CT,(n0t1TELUD4 70-5161
NAME OF APPLICANT �kl �601�eP.
ADDRESS PC) &-)C 163 6J-G;J_6ekW&6JJ J& 1-4646, TEL
BUSINESS NAME IF DIFFERENT: e_,4A0r45)1e 6AC-5
TYPE AND LOCATION
Check What Applies: Existing Perma-nent Projecting Sign
Temporary. Non-conforming Existing
Free-Standing Wall New
Location: Tax Map Number2-10- 1 - 7
Address ___Q
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Proposed Setbacks from Property Line (front) __ (side)
If sign is to be illuminated, please check appropriate box:
Internal) External Incadescent ) ,' Neon Other
Size of Sign: Width - ';—' ft. Length ft.
Total Square' Footage: _ 16
Sign Copy: owwr45le olio �Anle- AzIn
Color and Material To Be Used: ,4
Signature:
Zi"l One: <k[p�ican owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A: SIGN ON MY PROPERTY OR BUILDING.
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ORIGINAL-Office Copy -Applicant
518.732-7706 1-800.942-NEON FAX - 518 732 7716
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PRICE CHOPPER
QUEENSBURY�,N.Y.
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UEENSBURY,N.Y.
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