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Hoosier Orthopaedics & Sports Medicine S5.94
SIGN CPY: IWLP1Z ILJL e - r „��;� , SIGN ADDRESS: /OM/ 7717e. L�:1/ 1 CARMEL/CLAY TOWNSHIP,HAMILTON COUNTY,INDIANA / " SIGN PERMIT APPLICATION / f • DATE RECEIVED: J l j 4' PERMIT NUMBER: Q NAME OF BUSINESS:(��,L&t.e ,C LQ, 4* Jui PHONE:A - ADDRESS: /o 6)7 2 7/17aecka./A- CITY: ((OVINE,/ STATE:� ' - ZIP:7`4o0 3� PROPERTY OWNER Hear* $.(O-2 t b/,-ti( V� -1-M12-- PHONES-75. 76? ADDRESS: /i D/ A('• GA'/Vp2/D/4t,y CITY: ( 741--/a1/V-L STATE: /17 ZIP: ZONING DISTRICT: 13-‘ OVERLAY ZONE: 31 431 421 OLD TOWN: YES NO REQUIRED APPROVALS: Plan Commission Docket# BZA Docket# 1- -1,DOCD Only IS AN IMPROVEMENT LOCATION PERMIT REQUIRED FOR THIS BUILDING/TENANT SPACE? NI IF,YES STATE PERMIT NUMBER ISSUED SIGN TYPE-circle one: WALL GROUND ROOF PROJECTING SUSPENDED PORCH WINDOW OTHER NO. OF SIDES / SIGN STATUS-circle appropriate response(s112) EXISTING PERMANENT TEMPORARY OVERALL SIGN HEIGHT FROM GROUND: 9 FT. OVERALL SIGN DIMENSIONS: /i ' FT.X S F TOTAL SIGN AREA: Requested- (i l' SQ.FT. Permissible- 7C SQ. FT. COLORS: 44,`iT�X. • BUILDING OR TENANT SPACE FRONTAGE DIMENSION: (10 Lo FT. BUILDING TYPE:'4of t 1-6.4--Awr SETBACK OF SIGN FROM NEAREST RIGHT-OF-WAY: 2eV FT. LOGO DIMENSIONS: ! 1 / ,L000 IS A PERCENT OF ALLOWABLE SIGN AREA ARE THERE ANY EXISTING SIGNS ON THIS SITE? IF YES,EXPLAIN P412 • SHOPPING CENTER OR COMPLEX NAME: */-6,ei / & '2�'�, .r^ GI CERTIFY THAT A PICTURE OF THIS SIGN WILL BE SUBMITTED TO THE DEPARTMENT OF COMMUNITY DEVELOPMENT WITHIN ONE (1) WEEK AFTER ERECTION OF THE SIGN. -OR- I WOULD PREFER AN ADDED S35.00 INSPECTION FEE TO BE ADDED TO THE COST OF THIS PERMIT TO COVER THE COST OF THE STAFF OF THE DEPARTMENT OF COMMUNITY DEVELOPMENT TO TAKE THIS PICTURE. TWO COPIES OF THE FOLLOWING DOCUMENTATION IS REQUIRED FOR THE REVIEW OF THIS SIGN PERMIT: * -COMPLETED APPLICATION * -THE SITE PLAN (depicting all dimensions,setbacks and proposed sign location) * -SIGN ELEVATIONS(depicting all dimensions,copy and colors) * -BUILDING OR TENANT SPACE ELEVATION (depicting frontage dimensions and proposed sign location) * -LANDSCAPE PLAN, Required for ground signs(depicting the plantings,and mature heights and caliper) * See Samples Attached SIGN PERMIT FEES: -PERMIT APPLICATION....S 25.00 -SIGN ERECTION S 20.00 PER SIGN FACE PLUS S 1.00 PER SQUARE FOOT OVER 32 SQUARE FEET. -REPLACEMENT OF SIGN FACE IN AN EXISTING CABINET...S 25.00 PLUS S 1.00 PER SQUARE FOOT OVER 32 SQUARE FEET. (Continued On Page 2) Page 2 of 2 1 f Carmel/Clay Sign Permit Application 1 Zlic LiNDER6WNED'CERTIFIES THAT THE FOREGOING SIGNATURES,STATEMENTS AND ANSWERS HEREIN R,allaAINTED,AD TH. INFORMATION HEREWITH SUBMITTED ARE IN ALL RESPECTS TRUE AND CORRECT, ANCTHIS SIC'*IAVILL'BE ERECTED AND MAINTAINED IN ACCORDANCE WITH ALL APPLICABLE LAWS OF THE i STATE OF INDIANA,ANty THE "ZONING ORDINANCE OF CARMEL/CLAY TOWNSHIP,INDIANA AND ALL ACTS AMENDATORY THERETO,AND SHALL BE ERECTED WITHIN SIX (6) MONTHS OF THE DATE OF ISSUANCE OR THIS PERMIT IS NULL AND VOID. FURTHER,THE UNDERSIGNED CERTIFIED BY SIGNING THIS APPLICATION THAT ALL REPRESENTATIONS BY THE DEPARTMENT OF COMMUNITY DEVELOPMENT ARE ADVISORY. PROI RTY OWNER'S SIGNATURE BUSINESS OWNER'S SIGNAT RE PR�0 F- De.tAki Y Fite- / rro liA0.2,1)I N Ikl&�Loc-7Z f1GV4Jl )No PER OWNER'S NAME (PLEASE PRINT) � BUSINESS OWNER'S N E (PLEASE PRINT) SIGN COMPANY: 46r / S - CONTACT PERSON: /I' 7 L/_.. PHONE: U 3 - T • -20 ADDRESS: co. _ ,x .5--,6- CITY: -i-, ;iii STAT ZIP: �6 THE FOLLOWING ITEMS ARE CONCERNS BY STAFF OR PRIOR COMMITMENTS THAT MUST BE ADHERED TO A. A CONDITION OF THE ISSUANCE OF THIS PERMIT (PLEASE INITIAL EACH INDIVIDUAL ITEM): 1)x • 2)x 3)x 4)x 5)x SIGN PERMIT APPLICATION S SIGN ERECTION- Improvement Permit S So INSPECTION FEE (Required if photography not provided) S ?stip -172 13f, 07494(9f.47 TOTAL FEE S I'D‘ / PERMIT ISSUED BY: Ln1442 °T-- 9.1,1,r,CD, FEE RECEIVED BY: Ck WA( C� ithiff\'' RELEASED STAMP: PAID STAMP: 4.'''' isI 4j JAN 2 8 i9a4 Revised 7/17/90—m:\sign\permitl.app RECEIPT 0U 0078= 94 CITY OF CARMEL DEPARTMENT OF COMMUNITY DEVELOPMENT Carmel, IN 01/28/94 General Fund Received from Staley Signs. Inc. Total $ 105. 00 The SUM of One hundred five 00 /100 Dollars On Account of Hoosier Orthopaedics & Sports Medicine Address 01 N. Meridian Street Paym ype: CHECK permit $ 105. 00 Pgrmit No. S 5. 94 ) $ 0. 00 1/4\,,,__ $ 0. 00 Au orized i e. $ 0. 00 Signature /WV $ 0. 00 dep TOTAL $ 105. 00 FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR THE CITY OF CARMEL-1989 _ EXISTING "` PROPOSED I�.' - - BUILDING tz. 1 BUILDIIN4 © I . 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