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2006-263 Advance Rentals & Supply / • 1 OFFICE USE ONLY f lljj TAX MAP NO. ,5-I -R/ PERMIT NO. Olo DirS DEPOSIT: • ` ; APPROVALS: ZONING: TOWN CLERK: PERMIT FEE. O. • • • TEMPORARY SIGN PERMIT APPLICATION: Applicant Information Business Information Name: 4/j(/amu c A-1.,/4/7/f42444, Contact Person: ,�o s; ic. /,tri. Address: 39h Ciet,,24..cA , ,. Address: &)25)/ A// ,mob c y Phone No. 79z- 2 a Phone No. S"ip? Specific Information about your sign: ✓ What is the date for placement of your sign? 'v/-77/06- !!PR ? 7 2006 b ✓ What is the date for removal of your sign? ✓ How many days will your sign be displayed? &/62-/,c- - ✓ Indicate exact address for placement of sign: .S/.>� ✓ Indicate tax map number for your parcel: 2 3 ) OO-3o3 00.s- UUoi-o o/- ave,- 0006 ✓ Indicate the type of sign you will display: all Sign (cannot exceed 32 square feet) Freestanding Sign (cannot exceed 16 square feet) I, i, ✓ What are the dimensions of the sign? /f' X 15/ = wit. ft. ✓ Indicate in words what your sign will say: A/E ef/C/5G-s9 � -zcL.T- Sv/d Note: 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) Declaration: To the best of my knowledge, the statements contained in the application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premis- and that all provisions of the Zoning Ordifrance, and all other laws pertaining to the proposed • sha, be complied with, whether specified , noted, and that such work is authorized by the owner. APPLICANT SIGNATURE: ..i DATE: L G:: I hereby authorize the ar pl''ant t lace a sign on my property or building: OWNER SIGNATURE: / - - 6A- DATE: /1. Gt; Along with your application, please submit: QUESTIONS? CALL 761-8256 OR EMAIL codes Qqueensbury.net o Detailed drawing or photo of sign VISIT OUR WEBSITE FOR MORE INFORMATION o Plot Plan of location of sign www.queensburv.net CDTown of QueensbunyQueensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 ,.-7--.12gwrgiw"-'" -,- --- -. ' 11-1-11 11 -11 1 H H I In 7 : ' 1 1 , i /3/D6r -Xt 3 9 b 9610 (AnuST- 1/4A FET IS ' SET6Acic- tb Fgonti 'L .. 5 'if • • 11111.11111111111 MENEM MI m Immommome ummmummomm mummummommum moms mmummommommmimmummummummommommommimim mommimmmummE4mmEmmmewommummmommumommi mom summmimmommemommummummummomm mum mmommommummommummummummummomm - mmumummummummummummummermemmommimmummm ammummommimmimmaimmommilmommilliiiimill MEMMEMEmmmEMPRMMEMEMEMMEMMEMMEMEMMEMMEMMEM MEMEMMEMEMEMMEMMEMEMMEMMAMMEMMEMMEMIRMINI MILL ME INIMMEMMEMMEREMMEMMEMMEMMEIMMEMAIMMOMMIll • MMEMMEMMINIMMEMMEMMEMEMMUMMEMMEMEMMEMME . M111 MIIMMEMMMEMMEMMEMMEMEMEMMEMEMMEMINIMMEM IMIMM MMEMMEMMEMEMMEMEMMEMMEMMEMMOMMEMEMEM ' EMMEll MEMENIMMIMMEMMEMMEMMEMMINIMMEMEMEMM : MMINIMMOMMMEMMINIMMEMMEMMEMMEMMEMEMMEMMOMMEM mmummirmummummommommommimprommom mmomm mommommommummommommi mmommo mum mimmummommummommimmil •.••••••a•..•••.•••••• m•.••••••a•..•••.•••••• mommummummomm mom • mum mmommomm um um mimmommomm mom 11■■ ■■11■ MOM= ■■■■■■ ■■ ■■■u.0 ■■ ■■■■■■■■■■■■■■■■■■ ■■ ■■■1111■■■■■■■■■1111■ ■■ IMMNMMMIMMMMENMMMEMIMMIMMIMMMEM■ ■ UM 1111 ■ ■ ■ ■1111■■■■■ ■■ ■■ ■■ ■ ■■ ■■ ■■ .11 IM ■ ■ ■ ■■■ 1111■■■■■ ■■■■ EM ■■ ■1111■ ■■ ■■11 1111 ■ ■■11 ■■■■■■■ ■■■ ,■■■ ■ ■■■■■■■■■■■■■■ ■■■ ■■■■■■■11 � ©■■■■ ■ O■ ■ '.,- ■■■■■■■■■■■■1111 ■■■ ■■■■■••U •••11■ ■■ MME ■■11 ■■■■■■■■1111 ■■■■■■■■■1 ■�!!■■■■11 ■■IM ■■ E1MMMIMM MI ■■■■■■■■■■ ■■■1111■ ■■■W11O■■■■■ ■■■EM ■ 1111■ ■ ■■ ■■■ ■■ ■■■ ■■PERM■■■ ® ■1111■■ _ MME ■ ■■ ■■■■■■ ■■■ ■�■■MMIIM■ ■ ■1111■ ■ M0 ■1111■■■ ■■■■■■■■■■■■■■1111 r■■■■■ ■■ ■■ ■■■■■■■■■ ■■■■■■■ ■■■■■ ■■■■■■■ ■■ ■ ■■ i 1111■■■■■ ■ ■■11 ■■ ■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■ ■■■■■ ■■■■■ ■■■i ■■n■a%■■■J®m ■■ ■■■■■■■■■■ ■■■ ■■■■� aaa[ ■■■[•�M■■l■■■■`i■■■ 1111■■■■ ■■ ■ ■ ■C.MM ■L ..M■a■■■ ■■ ■1111■■■ ■■■ ■ ■■■ ■■■■a.■ ■■■ ■ ■■■■ ■■ 1111■■■■ ■■■ ■■ ■■■■■■■■■■■ ■ ■ ■ ■= ■ ■■ ■■■■■■■■■■ ■ ■ ■a1 ■I, � � , � � , ,-, =; , r-;-�-,= LAN) NOT 3 G a f.I rg c `' o r --- ,, rtN � Ac,I-I 6oA-(Ln " 51- ,I LE - 1221\ a I 3-/(qa j i11 I iiLiliii , LLLI I I I I I I I i i ihi