Orchard Park Presbyterian S125.93SIGN COPY: lZ41 —SIGN ADDRESS: OS 1n W L
CARMEUCLAY TOWNSHIP HAMIiTON COUNTY IND[ANA
SIGN PERMIT APPLICATION ��O�br
DATE RECEIVED:
PERMIT NUMBER: k 4S I 9;� 5 1
NAME OF BUSINESS: Q&Cg,
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PHONE: g4/#'%/,D7 --
ADDRESS: /64.5 E—•
ID6T/1 REST
CITYIAZ1,6NRPO2-15
STATE: /A) ZIP: ��22,0
PROPERTY OWNER: ,f-&' /S ?! �A3dl%, e' PHONE:
ADDRESS
CITY:
STATE: ZIP:
ZONING DISTRICT: S _1 OVERLAY ZONE: 31 431 421 OLD TOWN: YES NO X
REQUIRED APPROVALS: Plan Commission Docket # BZA Docket # DOCD Only X
IS AN IMPROVEMENT LOCATION PERMIT REQUIRED FOR THIS BUILDING/TENANT SPACE? A/b
IF, YES STATE PERMIT NUMBER ISSUED
SIGN TYPE -circle one: WALL (.(�ROUND J ROOF PROJECTING SUSPENDED PORCH WINDOW OTHER
NO. OF SIDES SIGN STATUS -circle appropriate response(s): NEW EXISTING PERMANENT) TEMPORARY
OVERALL SIGN HEIGHT FROM GRO FT. OVERALL SIGN DIMENSIONS: �{ FT. X 9j FT.
TOTAL SIGN AREA: Req sted- 2 SQ. FT. Permissible- 3_SQ. FT. COLORS: DORk �l2O� EIINHITE/ /lkA
BUILDING OR TENANT SPACE FRONTAGE DIMENSION: N FT. BUILDING TYPE: /iV-571y r) O Al
SETBACK OF SIGN FROM NEAREST RIGHT-OF-WAY: ks-Trj gLD B LVA 8/�4 T H. S
LOGO DIMENSIONS: I -'( 1 2,"� ,LOGO IS 2,� PERCENT OF ALLOWABLE SIGN AREA
ARE THERE ANY EXISTING SIGNS ON THIS SITE? IF YES, EXPLAIN (1) a'ZaXff t-O K- AC£� Gl2pr��I]'SAGA)
A.D
SHOPPING CENTER OR COMPLEX NAME:
;96:5 APARI
FROM ER-5 i 1
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 $35.00 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 .... $ 25.00
-SIGN ERECTION ......... $ 20.00 PER SIGN FACE PLUS $ 1.00 PER SQUARE FOOT OVER 32 SQUARE FEET.
-REPLACEMENT OF SIGN FACE IN AN EXISTING CABINET ... $ 25.00 PLUS $ 1.00 PER SQUARE FOOT OVER 32 SQUARE
FEET.
(Continued On Page 2)
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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 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.
"� -P-, I V- F - J" (' � �
J
?ROPE —AT ❑WNER'S SIGNATURE
L-oU15 T, sw' ""V'v
PROPERTY ❑WNER'S NAME (PLEASE PRINT)
BUSINESS OWNER'S SIGNATURE
BUSINESS OWNER'S NAME (PLEASE PRINF)
'Le'EF2 S(G/✓S
SIGN CONTACT PERSON:/� ��dT�� PHONE: �57I'219Q D
ADDRESS: ��oZ ,� 8EN. FLAc� CITY:I1--Di ,)� �/s STATE: A) ZIP: ZS�
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 INDIVIDUAL ITEM):
SIGN PERMIT APPLICATION
SIGN ERECTION - Improvement Permit
INSPECTION FEE (Required if photography not provided) $ 35.00
TOTAL FEE
PERMIT ISSUED BY:
:Ph�otowill�be ovide
FEE RECEIVED BY:
RELEASED STAMP: i PAID STAMP:
.`"ubjec. C'o!5' r ,..� �a >Vsfl'g 411 Regulations
Revised 7/17/90—m:\sign\permit Lapp'
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