2. Date*
   Date
4. Town Contact Information
   110 South Main Street
   P.O. Box 50
   Mount Airy, MD 21771
   
   Phone: 301-829-1424
   Fax: 410-795-4810
6. Project Address
8. Name of Business*
9. Email Address*
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Website*
20. Applicant Information
22. Sign Contactor Name*
23. Email Address*
25. Contact Name*
27. Address*
29. City*
30. State*
31. Zip Code*
33. Phone Number*
34. Fax Number*
38. Property Information
40. Owner Name*
41. Email Address*
43. Address*
45. City*
46. State*
47. Zip Code*
49. Phone Number*
50. Fax Number*
52. Sign Information
54. Property Frontage*
    Please enter the amount in linear feet of your property frontage.
56. Illuminated*

    1. Yes
    2. No
57. If yes, by what type?*
    For example: LED, Internal, In-Direct
59. Is there an existing sign?*

    1. Yes
    2. No
60. If so, what is the size dimensions?*
62. Sign 1 Description and Type*
64. Width*
    In feet and inches.
65. Height*
    In feet and inches.
67. Total square feet*
69. Number of faces*
71. Upload Color Rendering of Proposed Signage*
    Please include the sign dimensions on the color rendering upload in order for your application to process.
73. Sign 2 Description and Type*
75. Width*
    In feet and inches.
76. Height*
    In feet and inches.
78. Total square feet*
80. Number of faces*
82. Upload Color Rendering of Proposed Signage*
    Please include the sign dimensions on the color rendering upload in order for your application to process.
84. Note of Caution
    I/We have carefully examined and read this application and know the same is true and correct. I/We are also aware that whoever is indicated as the contractor assumes full responsibility for this application and will comply with all provisions of the Town of Mount Airy and State Laws.
86. eSignature of Applicant*
    By typing your name, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
88. Notes
Leave This Blank:


90. 1. Receive an email copy of this form.
91. Email address

    This field is not part of the form submission.

92. Submit Submit and Print

* indicates a required field