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City Of Blackfoot 157 N Broadway St Blackfoot ID 83221 [PHONE REDACTED] www.cityofblackfoot.org Filing Fee $25.00 (Per Sign) APPLICATION FOR A SIGN PERMIT (On and Off-Premise Signage) Permit _ Submittal Date: Contact Name: Receipt Receipt Date: Sign Contractor Information: Business/Site Information: Name:_ Address: Phone: Name: Address: Phone: Zoning: Historic District: Yes No Type of sign(s): Illumination Source: Dimension of Face(s): Power Source: Existing New Height (from ground level to top of sign): Total Sign Area Existing on Site (include all painted wall signs, pole signs, and window signs): Building Frontage (per street front): Open Space (per street front): Multi-Use Facility (more than one tenant in bldg.): Yes No THE FOLLOWING INFORMATION MUST ACCOMPANY EACH APPLICATION 1. A site plan which includes: the site with street locations, lot frontage dimensions, building locations(s), building frontage dimension, open space dimension, landscaping, location of all existing and proposed signage with setback dimensions from property lines, and the dimensions of said signs. 2. Schematic drawings of the proposed sign(s) which indicate dimensions, height, colors, message, type of illumination, and construction materials. 3. Structural details showing mounting to a building or pole (pole size, anchoring, concrete footings, etc.). 4. Photographs of the site showing building and proposed location of sign(s). Page 1 of 2 ---PAGE BREAK--- IF THIS PERMIT IS FOR REUSE OF NONCONFORMING SIGNAGE, THE FOLLOWING MUST ALSO BE PROVIDED: 5. Documentation that the message of the existing sign has not been incorrect for over one hundred eighty days. Such documentation may include lease papers, utility records, or the like. 6. If for a new business, estimates for the cost of refurbishing the existing sign and installing a conforming replacement. The undersigned applicant and/or applicant’s representative hereby agree to indemnify, protect, and save the City harmless from all costs, loss, or damage which may be sustained by reason of the erection, maintenance, use, or removal of the sign(s), and that the sign(s) may be removed as provided in the City ordinances. The approval of this sign does not permit the violation of any section of this or other City ordinances. I/we hereby acknowledge that I/we have read this application and certify that the information provided is correct. Further, I/we understand that it is my responsibility, as the sign contractor, to secure a sign permit prior to commencement of any work, including fabrication and installation of said signs. A permit should be available in the City Planning & Development Services Department 5 working days after the submittal of a complete permit application. Further, by my signature below, I acknowledge that any and all conditions will be adhered to and are understood, that all work will be done in accordance with the issued permit, and that I am authorized to do so by the building/property/business owner. Signature of Sign Owner Date Signature of Sign Contractor Date Signage should be completed within ninety days of obtaining a permit. Permits and exceptions are not transferrable. SEE ATTACHED SIGN PERMIT CHECKLIST FOR CITY’S APPROVAL SIGNATURE AND STAFF COMMENTS and REQUIREMENTS FOR THIS SIGN PERMIT. Staff Use Only Below This Line PERMIT INSPECTION - P & DS Date: By: Status/Action: SIGN & ELECTRICAL INSPECTION - BUILDING Date: By: Status/ Action: Page 2 of 2