Application for Sign Permit

Bloom Township, Fairfield County, Ohio

Please note: fill in your details on screen, then print and sign in ink. Signatures must be original — not faxed, copied, or electronic. Make checks or money orders payable to Bloom Township.

Per Bloom Township Zoning Resolution 412–414, all permits are conditioned upon commencement of work within one year of filing. If work is not completed within 2 years of issuance, the permit shall expire.

Applicant

Name of property owner (required)

Phone

Parcel # of property for permit

Address of property where permit is to be issued (required)

Mailing address

Size of lotacres

Road frontagefeet

Measuring from the building line, indicate how many feet your sign will be from:

1. Front building linefeet

2. Rear of sign to rear yard linefeet

3. Side of sign to right side yard linefeet

4. Side of sign to left side yard linefeet

5. Total height of signfeet

6. Total square footage of signsq. ft.

Attach to this application:

Legal survey.
Site plan, drawn to scale, showing the actual dimensions and shape of the lot, the size and location of existing buildings (if any), and the location and dimensions of the proposed sign or alterations.
Zoning application fee — see the fee schedule for the amount.

Full sign regulations are in Article X of the Zoning Resolution.

Certification (sign in ink after printing)

I certify that the information supplied in this application is true and correct and that all information requested has been supplied with this application.

Applicant

Date

For office use only

Approval for

Denial (state reason)

Zoning Processor

Date

Anne D. Cyphert, Zoning / Board Administrator

Date