Sign Permit Application Form - East Manchester Township
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1East Manchester Township
Tax Map #_____ Parcel #_____
SIGN APPLICATION
Application Date
_________________________
Applicant Name___________________________________________________Telephone #__________________
Address_____________________________________________________________________________________
PROPERTY OWNER INFORMATION
Note: written consent of the owner is required, if not the applicant.
Name(s)_________________________________________________________Telephone #__________________
Address_____________________________________________________________________________________
PROPERTY INFORMATION and SIGN LOCATION
Address_________________________________________________________________ Zoning District_______
Any right-of-ways/easements? No___ Yes
__________________________________________________
(describe)
Special Exception/Variance granted: No___ Yes
_____________________________________________
(describe)
Value $_________________
Proposed Use: Non-Residential____
Residential____
SIGN INFORMATION
Type of Sign_________________________________________________________________________________
Sign Dimensions_______________________________________________= total square footage_____________
Attach detailed plans and specifications for the proposed sign(s) including any lighting, and location to any building
or land, with its position in relation to nearby buildings or structures and streets.
Illumination: none_____ or by indirect lighting____(R zones not between 11pm and 6am) or by direct lighting_____
Colors____________________________________________________ Note: red, green, amber, or high reflection
may not be located within a 200’ radius of a traffic light or similar device or from center of any street intersection.
Flashing, rotating, and intermittent lights are not permitted.
CONTRACTOR/INSTALLER INFORMATION
Name_______________________________________________________________________________________
Address_________________________________________________________Telephone #__________________
Person in charge of work____________________________________________Telephone #__________________
Insurance Information: Certificate of Insurance currently on file with East Manchester Twp______
Workers Compensation Insurance Company________________________________________________________
policy #________________________________ expiration_____________ or EXEMPTION_______
Liability Insurance Company_____________________________________________________________________
policy #________________________________ expiration_____________
Agent__________________________________________________
Phone Number_______________________
Address_____________________________________________________________________________________
Signs may not interfere with any clear sight triangle, project over a sidewalk or street, and may not obstruct
pedestrian traffic.
Signs must be kept clean, neatly painted, free from all hazards, and in safe condition.
Signs must adhere to Section 255-62 of the Code of the Township of East Manchester, Zoning, Article 6.
The applicant hereby makes request for a permit under all applicable Codes of East Manchester Township and hereby certifies,
under the penalties of perjury, that all facts set forth above are true and correct and the actual work will be performed in
accordance with the above.
____________________________________________
Owner or Owner Agent's Signature
7/27/10
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