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CITY OF CARMEL
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
PARCEL ID 1610300301003501
DATE ISSUED.......: 10/15/2007
RECEIPT #......... 26545
REFERENCE ID # 07100077
SITE ADDRESS 23 MAIN ST E
SUBDIVISION .......
CITY CARMEL
IMPACT AREA .......
OWNER DR LARRY LEY
ADDRESS ..........
CITY/STATE/ZIP ...: CARMEL, IN 46032
RECEIVED FROM ....: AD POINT INC
CONTRACTOR .... LIC #
COMPANY ..........
ADDRESS ..........
CITY/STATE/ZIP ...:
TELEPHONE ........
OPERATOR: rboone
COPY # : 1
FEE ID UNIT
QUANTITY
AMOUNT PD-TO-DT
THIS REC
NEW BAL
SIGNINSTAL SQUARE FEET
^^^ 8.00
M- 80.58
0.00
80.58
0.00
SIGNPERM FLAT RATE
1.00
83.00
0.00
83.00
0.00
TOTAL PERMIT
�� ~163.58
0.00
163.58
0.00
METHOD OF PAYMENT
AMOUNT
NUMBER
CHECK
163.58
8672
TOTAL RECEIPT _ 163.58
SIGN COPY �� � LLB � UV_ SIGN ADDRESS Z 3 E MA l 1V 1
C[TY OF CARMEVCLAY TOWN H[P HAIv1iLT N COUNTY INDIANA
SIGN PERMIT APPLICATION �7 /77�
DATE RECEIVED: I . (� , ! I — v" PERMIT NUMBER: _ O I I vy �
NAME OF BUSINESS L ® —�-- PHONE:
ADDRESS: �.ra7 _ M.A I_♦,4 ST �� CITY: _C .M �- STATE: __UN_zIP: 400 3 Z
PROPERTY OWNER a_ �`I LCr`j PHONE. �J S— gS% G
ADDRESS: CITY: STATE: ZIP:
ZONING DISTRICT: L OVERLAY ZONE: 311 421 -7 4311 OL TOWN: YES NO
REQUIRED APPROVALS: Plan Commission Docket # L �+ �A Docket#
IS AN IMPROVEMENT LOCATION PERMIT REQUIRED FOR THIS BUILDING/TENANT SPACE?
IF YES, STATE PERMIT NUMBER ISSUED
SIGN TYPE -circle one: WALL GROUND ROOF ROIEC SUSPENDED PORCH WINDOW OTHER
NO. OF SIDES 2 SIGN STATUS -circle appropriate response(s : NEW EXISTING ERMANE TEMPORARY
OVERALL SIGN HEIGHT FROM GROUND:. 0 Fr. OVERALL SIGN DIMENSIONS: 4 FT. x Z FT.
G S .FT. COLORS: BEAC.1~_
TOTAL SIGN AREA: Requested SQ.FT. Permissible Q
BUILDING ORTENANT SPACE FRONTAGE DIMENSION: 7i FT. BUILDINGTYPE: (1 ULT1�I�nlAtsr MVITI-L
SETBACK OF SIGN FROM NEAREST RIGHT-OF-WAY:-12-
LOGO DIMENSIONS: fu f /A , LOGO IS PERCENT OF SIGN AREA
ARE THERE ANY EXISTING SIGNS ON THIS SITE? IF YES, EXPLAIN N O
SHOPPING CENTER OR COMPLEX NAME: V —rVLA-J Y U -''
/\ I CERTIFY THAT A PICTURE OF THIS SIGN WILL BE SUBMITTED TO THE DEPARTMENT OF COMMUNITY
SERVICES WITHIN ONE (1) WEEK AFTER ERECTION OF THE SIGN.
-OR-
I WOULD PREFER A $104.00 INSPECTION FEE BE ADDED TO THE COST OF THIS PERMIT TO COVER THE
COST OF THE STAFF OF THE DEPARTMENT OF COMMUNITY SERVICES TAKING THIS PICTURE.
TWO COPIES OF THE FOLLOWING DOCUMENTATION ARE REQUIRED FOR THE REVIEW OF THIS SIGN
PERMIT:
* COMPLETED APPLICATION
* SITE PLAN (depicting all dimensions, setbacks and proposed sign location)
* SIGN ELEVATIONS (depicting all dimensions, copy and color)
* BUILDING OR TENANT SPACE ELEVATION (depicting frontage dimensions and proposed sign location)
LANDSCAPE PLAN: Required for ground signs (depicting the planting, mature heights and caliper)
See Samples Attached
SIGN PERMIT FEES:
-PERMIT APPLICATION ........................... $83.00
-SIGN ERECTION ....................................... $33.25 PER SIGN FACE PLUS $1.76 PER SQUARE FOOT
-REPLACEMENT OF SIGN FACE IN AN EXISTING CABINET--$33.25 PLUS $1.76 PER SQUARE FOOT
(Continued On Page 2)
I�,(O_ 30 -O3 -Of- 065.5C)
Page 2 of 2
Carmel/Clay Sign
Permit Application
THE UNDERSIGNED CERTIFIES THAT THE FOREGOING SIGNATURES, STATEMENTS AND ANSWERS HEREIN CONTAINED
AND THE INFORMATION HEREWITH SUBMITTED ARE IN ALL RESPECTS TRUE AND CORRECT, AND THIS SIGN WILL BE
ERECTED AND MAINTAINED IN ACCORDANCE WITH ALL APPLICABLE LAWS OF THE STATE OF INDIANA, AND THE
ZONING ORDINANCE OF CARMELICLAY 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 REPRESENTATIVES OF THE
DEPARTMENT OF COMMUNITY SERVICES ARE ADVISORY.
PROPERTY OWNER'S NAME (PLEASE PRINT)
BUSINESS OWNER'S SIGNATURE
v4ck,l D j5d \n
BUSINESS OWNER'S NAME (PLEASE PRINT)
SIGN COMPANY:. L7N A 9 MA CONTACT PE�RS,ON",,` 12A J i5 'HONE: s 7S 1807
ADDRESS: 9ct g l-J' CAPY'M t-- DR- CITY: CA/2'" � CL STATE: 4J ZIP: -%Q32—
THE FOLLOWING ITEMS ARE CONCERNS BY STAFF OR PRIOR COMMITMENTS THAT MUST BE ADHERED TO AS A
CONDITION OF THE ISSUANCE OF THIS PERMIT (PLEASE INITIAL EACH ITEM INDIVIDUALLY):
5)
SIGN PERMIT APPLICATION $ !'
SIGN ERECTION -Improvement Permit $ (71)+I.7 s-F; 0•SS
INSPECTION FEE (Required if photography not provided) $104.00 OR oto will be r v' ed
TOTAL FEE $ 13 • 0
PERMIT ISSUED BY: FEE RECEIVED BY: vVVV►I- i//U lD Y
RELEASED STAMP: PAID STAMP:
ppa�d�
OCT 1�22007 � OCT � 5 RE
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revised 04/13/05 By (1
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QTY (1) 2-SIDED
48" X28" BLACK CUSTOM SHAPE PAINTED MDO
1 /41' SILVER PAINTED 6M1 L PVC LETTERS
SCROLL BRACKET
(9.3 SQ FT)
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