Sign Permit Date(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Applicant(Required)Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Owner Name(Required)Sign Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Greatest dimension of Building (height, width, or length)FREE STANDING SIGN (Only one per parcel)If there are no existing freestanding, elevated or ground signs complete items 5-10. If you are completely REPLACING the existing sign begin at #1Is this sign a REPLACEMENT?(Required) Yes No 1. Existing SqFt2. Existing Height:3. Existing Front Setback:4. Existing Side Setback:Note: Side setback is from property line closest to sign. Front setback is from the centerline of road. 5. Ground, Elevated or Billboard ?(Required)6. Height(Required)Above Freeway(Required) Yes No 7. SqFt(Required)8. Front Setback9. Side SetbackSide Direction11. Lighted Yes No 10. Message Center Yes No WALL SIGNS1. Existing Wall #1 SF2. New wall #1 SqFt3. Replacement? Yes No 4. Existing Wall #2 SF5. New Wall #2 SqFt6. Replacement? Yes No 7. Side Entrance SF:(Permitted only when 2nd entrance is at side or rear, for public use, and is served by a parking lot. Square footage included in maximum aggregate.) OTHER TYPESAwning, Marque, Suspended, Subdivision ID, Temporary {A-frame, Banner, Trailer, Wind}Other type #1Other 1 SqFtOther Type #2Other 2 SqFtOther Type #3Other 3 SqFtFor temporary signs only Expires OnVARIANCEVariance Requested? Yes No ZBA DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Variance ResultCommentsAPPROVALSTotal Cost of Sign(s)Sign Permit FeeApplicant Consent(Required)I agree to using an electronic signature. By mouse/finger signing, file upload and/or typing my name below, I agree to using an electronic signature.I am unable to use finger/mouse or file upload to sign and will only type my name in "Signature Typed" box below.Ignore this input if you plan to sign by finger/mouse or file upload. Yes Applicant SignatureI am uploading my signature instead of finger/mouse signing.I choose to upload a digital version of my signature.Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 512 MB.Typed Applicant Signature(Required)I certify all information provided is correct. False or inaccurate information shall void this permit and may result in removal of any work done under this permit. Return to: 2010 S. Lincoln Rd, Mt. Pleasant, MI 48858 or FAX to (517) 773 1988DateThis field is hidden when viewing the formApproval DateThis field is hidden when viewing the formApproval SignatureConsent(Required) I agree to the Privacy Policy and Security Notice. Δ
