Application for Permit Demande do permis

210- WI StOIi Sb,st
Application for Permit
Demande do permis
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204) 94!.B012
B45E912
Advertising Sign Application
Demande Pour Penn eauz Publicitaires
Instniction Sheet
Dlrectfres
Please print on Appllcmlon Form
Pdère d’écñre
L
Application Fee
A fee of $5Qtm must be ,bmitted with this appkatici. Please
make cheque payable to the;
Minister of Fmairo of Manitoba
TI.
Application for the Erection of an MvertisinglCommercial
Sign shal Fclude a diaam. thatch or map irdcating;
Proposed location
Distance horn right-of-way (pioperty line)
Size of sign
Design of sign risplaying the contents, etc.
MI e,dstg signs, accesses and stn,ctwes hc1uth
setbacks
on
camcléres d’imprirnere
CoOt du pennis
Joigna, 50 doflws b’otm domande. L,beeez vobo cheque a
I’o,d,e du ,ntnlstm des Finances thi Manfto&
a
II.
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Les demandes ,tatives I I’ddir,cation d’un pannenu
pubikitake cu d’,m panneau comnmrical doivent ête
soumises svec no diagramme, Un cruquis ott une cane
compmnanf fes ,onsefgnemens sufrvanfr
rapaiiient pro/eM;
o,fèP.s,,ae 7Ste c*, b’-b;
b Lj -r
-
-
-
-
-
-
-
-
los dhne,,sions ki pam9eau;
mi coiwuis du anneau, de air, conta,u, eta;
Ins cons minions, les pamleaa at los vtes daccés
th,si quo Jour &stance par ‘ofl a mole.
REMAROUES
NOTE
•
ALL APPLICATIONS MUST HAVE REGISTERED LAND
OWNER’S SIGNATURE
•
rOUTES LES DEMANDES DOIVENT PORTER
SIGNATURE DU PROPRIETAIRE FDNCIER INSCRIT
•
Land Title Certificate or a copy thereof must accompany this
application.
•
L’origlnal on une copie du ce,ttflcat do litre kinder dolt être
joint a Is demanda
•
Use “Site Plan” of this Application for sketch or for added
information. Use both sides, if required.
•
La section plan du site” est iservde aix cmquis et aux
,unseignements supplemon taims. SI oflo no stsffit paz utilisex
Jo versa do Is fenille.
•
Application will not be processed until ALL Information Is
submitted.
•
Los domandes no soot pas etudlees tent queues Re soot pas
compMtos.
Applicant
Remove and retaIn Ihis instruction sheet and “Applicant Copy;
forward balance of completed application and fees tome Highway
Traffic Board at the above address.
THIS APPLJCA11ON, IF APPROVED, DOES NOT DISPENSE
WITH THE HOlLER ThEREOF COMPLYING WrrN ALL TERMS
AND CONDrnONS OR ANY MUNICIPAL BY-LAW OR ZONING
REGULATION.
Inforrnatbo.i on the sign conditions poUcy can be obtained horn the
Ffighway Traffic Boards olfices. municipal offices or cfistict offices.
MG-IO79 (Peised i’t6
thiatni irrinhj
outcr
Au ,quémnt
Veuiffez conserve,- los directives et Ia capio iteivde nu mqudmnt.
Envoyez votre paienwnf et lo reste do Ia demande an Constil
mutter a Padmsse susmentionnee.
riiflnJLA,RE DUNE DEMANDE APPROUVEE NEST PAS
DISPENSE DOBSERVER LES CONDITIONS DU PERMIS.
DES ARRETES MUNICJPA(JX U DES REGLEMENTS DE
ZONAGE
Pour do plus an,ples mnseignements sur ía poIfliue ayant trait flux
pannx. veufllez contacter los buma,jx ,mjnidpaux. los bumaux do
district cc los btnaux du Ca,seif mufie
I rr In I C
nflhIetn
I,—.flfl.I
_____________de
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___________
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___________
______
___________
___________
Application for Permit
Demande de permis
Masiltabe
Tnmpodafiun and
2W1 l Weston Sheet
Wnp€q, Mitct
ThoItinaY
Tratrc Dd
O4) 45-OOI2
-
1) 45-S?l2
ADVERTISING SIGN
ANNE4U PIJBUCITAJRE
PicfflnI
ei Leins Mozos
%4uez codior LAOS CU pkssieu., c
Check
one
ntis of the foIIowWiq:
alit. be Y&doo. bnsu2I
WJmiipg lmDltha)
Wanspods et
Salon goINen.menIsu*
SIGN? PANNEAU
Off-Promises
On-Premises
instaffO lextedeur
du bien-tonds du
mqué rant
mstalie stir
Non-foods dii
raqué rant
a
C)
Ughted
‘liurnine
Sign to be! genre dc panneaux
V Shape
en fcwn,o cia V
Portable
Penylaneni
portatif
pem,a,ont
mnthaeds
n,ois?sen,afnos SW est ternpombo
Tenom,y
tempaa&e
It Tnpory For
pour
Proposed Usage / utulsation pmjetde
Htoiieai
r Con,snaruW
hista’*?Le
•
Conimsiiiy
fl
Renewal
Renouvollement
Single-lacod
D dun
soul caIê sueIwn,t
Double faced
D wi
rcto.veso
Oth (Please slate)
aiib Ththe,
caw,xm,Iae
comnietriaie
Not Lighted
non illumine
CI
SIGN LOCATION! EMPLACEMENT DU P.4NNE4U
km to the noa,t community.
To be located
Adjacent to-Highway #
Adjacent ala mute ,f__________ .Devant être installé a
highway
Land Frontage
rn
La façade donoant sur Ia mute ast cia
kn do Ia Iricalité ía plus pmcMe.
on
km IToh service pertrnai. Qkz atf-ç.mnisas signs o.y.)
Jun thi sendce orbit tour les pn,eaa Ieztdfle.r do bien-knds
To be localod
Dei,ant êtro ins!age a
a
[]s
DtebaslftieduteQN
I
1
Quarter
R.LJD.T.M.
L.R.ILMR.
I
iotI
I
sectionl
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I
I
RMjLSD. of
M.R?D.AL. otf
Certificate of Title No.
du tits fonder
I
totTTs111pI
Rangel
I
I
I
1
Block
I
Townshipl
Pa,ishof
1
PJUISS
I
LoEI
Qw(O)delarwta
DE
Section’
I
I
quaster
I
flail
Qty,TawnVageCopirmrttyofI
vffle, vi#age.Socakte______________________________
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J
&aWaU
1
Land Ths Office
dOS UtIBS MVICIe$S dJ__________________________
I
I
N°
Selback
popdétai,o).
side&thoh9iway.
To be located cii the
Le panneau est situé
mi
from the highway right-of-way (property line).
I’emphse deJa route (limitu do bien-fonds).
a
SIZE AND DESIGN I DIMENSION fT CONCEPTION
Size olsigrt
-
S.gntoface
Lap nmauta?tbaQN
Os
Dw(o)
D
Sign Message Conjeot:
Massage cki pmn
Distance from nearest sign
Distance dv panneau le plus prodie
D
CERTIFICATiON !ATTESTATION
I hnby ctify that Pie kifonilat ion herein contained is correct
JO cartitie, par ‘a présente attestation, quo los renseignenionts de Is
N
[1
s
G
E
1]
W (0)
LANDOWNER I PROPR!ETA/RE FONCIER
denjande sont exacts:
I Inby it pennssaI ‘a
for the puq’osa of etecting the sign he,.in desotod on the poperty descited
above. I also grad pwrun to ajjKdz.d persomid to ent the W Ia the
pIZpS of Wpetiig. arm*lg, ,flrpg, tai,g wid ra1iov’g the sign.
APPLICANT / REQUEI3ANT
Par los prdsentes. Jo donno (a pennisslon a
(please print) / (camctems d’imprimerie)
dédgar le panneau dócdt ci-dessus stir le b,en-mnds susmenflonne. Jo
donne Ia permission so personnel autodsd do pendtrer sue le blon-fonds en
question pour procéder linspection, a lerection, a ía ,pamtion, a Ia
lenlevement du panneau.
modification
LANDOWNER I PPOPRIETAInE FONCISR
(please print) ! (caiacMms d’imprimorie)
Name Nom
eta
Address Admsse
Pruv.
Postal Code Postaie
I
I
wiattHo
RepresentIng
te requemnt représente
I
a
Tel. No. Pt do tél
Flome No. Pt *n*i
Date
FOR OFFICE USE ONLY REBEA yEA L’ADMINISIRATIQN
—
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