Permit No. ______________
Index No. ______________

APPLICATION FOR SIGN PERMIT

MILLCREEK TOWNSHIP
ERIE COUNTY, PENNSYLVANIA

I, the undersigned, hereby make application for a permit to place a portable sign at ________________________________
__________________________ Zoning District ______________________ Height and Area _________________

Sign to be no larger than 32 square feet.  Sign to be at least ten (10) feet back from front property line and be at least ten (10) feet from the side property line.  
The sign is:  Illuminated _____, Non-Illuminated _____  (Flashing Promotional Signs are Prohibited)

The permit number label will be placed on the sign in a visible place.  The type, location and size of proposed sign is correctly set forth hereon.  The construction of the sign will conform to Township Building Codes and pertinent Ordinances.  Electrical signs will be inspected and certified by an electrical inspection agency prior to electrical use.  A written certification of inspection will be provided to the Township.

Signs will be removed from site no later than 90 days from the issue date of permit or deposit will be forfeited to Millcreek Township.  The Township Secretary will be notified by applicant to return deposit if not forfeited.  Failure to remove sign after 90 days and/or failure to conform to regulations of Millcreek Township Sign Ordinance No. 88-21 may result in a fine up to $500.00 plus prosecution costs.

Signature - Agent for Sign Company Sign Company Name and Address

Print - Agenty for Sign Company Sign Company Phone Number (incl. Area Code)

Signature - Property Owner or Agent Address

Print - Property Owner or Agent Property Owner Phone Number (incl. Area Code)
 

PORTABLE SIGN PERMIT
MILLCREEK TOWNSHIP, ERIE COUNTY, PA

THIS IS TO CERTIFY that Sign Permit No. _________ has been issued to ____________________________________, to place a portable sign at _________________________________ for a period of no more than ninety (90) days as per information on above application.  This permit is issued on the express condition that the proposed sign conforms to all applicable ordinances regulating the erection of signs in the Township of Millcreek.

____________________________, Zoning Officer Date Issue: _____________
Fee Paid $___________                   Deposit Paid $_____________

NOTE:  Sign permit null and void if sign not erected within six (6) months after date of issue.