2. Sign Owner*
3. Location Address*
5. Location City*
6. Location State*
   -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
7. Location Zip Code*
9. Lot Number*
10. Block Number*
11. Subdivision*
13. Liber*
14. Folio*
15. Election District/Tax Account Number.*
17. Owner of Premises'*
18. Owner's Phone Number*
20. Owner's Mailing Address*
22. Owner's Mailing City*
23. Owner's Mailing State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
24. Owner's Mailing Zip Code*
26. Type of Work*

    1. Erect new sign
    2. Replace existing sign
    3. Reface or alter existing sign
    4. Validate existing sign
27. Type of Sign*

    1. Ground (freestanding)
    2. Building - Roof
    3. Building - Projecting
    4. Billboard (off-site advertising)
    5. Temporary real estate (up to 6 months)
29. Total Street Frontage*
    Feet
30. Width of Building Front*
    Feet
32. Location on Premises*
34. Principal Wording*
36. Individual letters of attached directly to Fascia Building*

    1. Yes
    2. No
37. Construction Cost*
39. Dimensions of Sign*
40. Total Area*
    square feet
42. Distance of main building from front street line
44. Height to top of sign abovegrade from sign base*
46. Height to top of sign above roof line or parapet wall*
48. Maximum projection past the building wall*
50. Other signs on premises?*

    1. Yes
    2. No
52. 1. Permit Number
53. Type
    -- Select One --GroundBuildingBillboardTemporary real estate
54. Dimensions
55. Location on Premises
57. Principal Wording
59. 2. Permit Number
60. Type
    -- Select One --GroundBuildingBillboardTemporary real estate
61. Dimensions
62. Location on Premises
64. Principal Wording
66. 3. Permit Number
67. Type
    -- Select One --GroundBuildingBillboardTemporary real estate
68. Dimensions
69. Location on Premises
71. Principal Wording
73. 4. Permit Number
74. Type
    -- Select One --GroundBuildingBillboardTemporary real estate
75. Dimensions
76. Location on Premises
78. Principal Wording
80. 5. Permit Number
81. Type
    -- Select One --GroundBuildingBillboardTemporary real estate
82. Dimensions
83. Location on Premises
85. Principal Wording
87. Special Notes
    Building Permits are required for ground, all roof and building signs projecting more than fifteen (15) inches from the wall and/or more than 100 square feet in area.
    Electrical Permit is required for a mechanical or illuminated sign. Attach 3 copies of a scaled drawing of the proposed sign.
    Attach 3 copies of a scaled site plan of the property, if free standing sign.
89. Digital Signature*

    1. Signed

    I hereby certify that I have the authority of the owner to make the foregoing application, that the application is correct, and that the sign erection will advertise the legal use located on the same property as the sign and conform to the Zoning Ordinance and the Building and Electrical Codes, as appropriate.
91. M-NCPPC Use
Leave This Blank:


98. 1. Receive an email copy of this form.
99. Email address

    This field is not part of the form submission.

100. Submit

* indicates a required field