APPENDIX A
APPLICATION FOR SIGN PERMIT
(Please print)
APPLICANT                                                                                                              
          (Name of property owner or business representative)
ADDRESS                                                               CITY                                         
ZIP                                                PHONE ( )
NAME OF BUSINESS WHERE SIGN ERECTED:                                                                                           LOCATION OF SIGN: Street Name & Number                                                                  
Zoning District                                               
TYPE OF PERMIT:    ( ) PERMANENT ( ) TEMPORARY* (Maximum 7 days)
* If temporary permit, indicate requested first day of use                             
* If permit is temporary, the final day of display is                                      
TYPE OF SIGN:
______Wall Sign (s)    Bldg. Frontage                                  ft.
    Sign (1)    Area                      sq. ft.   Height to bottom of sign                       ft.
    Sign (2)    Area                      sq. ft.    Height to bottom of sign                       ft.
   Sign (3)   Area                     sq. ft.   Height to bottom of sign                       ft.
______Awnings & Canopies    Building Frontage                               ft.
   Sign area                            sq.ft.    Nameplate below Canopy                   sq.ft.
   Height to Bottom of Awning or Canopy              ft.   Setback from curb                    ft.
______Window Sign (s) Bldg. Frontage       sq. ft. Total Window Area         sq.ft.
Sign Area         sq.ft.
______Directory Signs    Number of Building Tenants                                
   Total sq.ft. of Sign Area                                                   sq.ft.
 
      Total Wall Sign Area = Total of all of the above                                 sq.ft.
 
_______Projecting Sign    Building Frontage               ft. Sign Area                           sq.ft.
    Height to Bottom of Sign                                 ft.    Setback from curb                   ft.
 
FREE-STANDING SIGNS: Lot Width                                       ft.
______Ground (monument) Sign Sign Area                           sq.ft.    Height to top                ft.
   Side yard setback                           ft.    Setback from Street R.O.W.                   ft.
 
______Pole Sign    Sign Area                            sq. ft Height to top                        ft.
    Sideyard setback                           ft. Setback from Street R.O.W.                         ft.
    Height to Bottom of Sign                                  ft.
 
INCIDENTAL SIGNS
______Banners         Number of Signs             Total Area                         sq.ft.
______Other Type                        Number of Signs             Total Area                         sq.ft.
 
   Applicants shall provide a site plan and other signage plans, sign sketches, etc. in sufficient detail to show the location and size of all existing and proposed signs in relation to street R.O.W., property lines, buildings, above ground utilities, etc. with accurate dimensions, plans for means of attachment or support, and proposed method of lighting if applicable. Before digging or boring holes for the erection of any free- standing sign, the applicant should check with local utility companies for location of buried facilities.
   NOTE: It should be understood that Village approval for a sign permit does not waive the applicant's responsibility for compliance with all applicable building and electrical codes of Richland County and/or the State of Ohio.
                                                                                                                                                                
   Signature of Applicant Date
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * *
Based upon the above information, a ( ) Permanent ( ) Temporary
Sign Permit is ( ) Approved ( ) Disapproved
                                                                   ______________________________
   Zoning Inspector Date