Application for Read-O-Graph Mobile Sign Permit
Development and Compliance Services
For Application Inquiries: 519-661-4555
Email: building@london.ca
CONTACT INFORMATION:
Sign Owner CONTACT INFORMATION: Applicant (if different)
Name: Name:
Address: Address:
City: City:
Phone: Phone:
Email: Email:
Mobile Sign Operator’s Licence Number (if applicable):
Location of Sign (address):
PERMIT INFORMATION:
Permit Sticker Number(s):
PAYMENT:
If you don’t wish to pay with cheque, please provide payment information below:
Name on Card
DECLARATION:
The undersigned agrees that the read-o-graph mobile sign(s) set out above in this application shall comply with
all applicable provisions of the City of London’s Sign By-law No. S.-5868-183 (as amended) and related
agreements with the City applicable to the subject lands. The undersigned further acknowledges that any
read-o-graph mobile sign set out above in this application displayed in the City of London that is not in
compliance with all applicable provisions of the City of London’s Sign By-law No. S.-5868-183 (as amended)
may be subject to immediate removal by the City.
I, (please print) ______________________________________, the undersigned, certify that the statements
herein contained in the said application are true and made with full knowledge of the circumstances connected
with the same, and acknowledge that I have read and agreed to the Declaration contained above.
London, Ontario (date) __________________ x signature _________________________________________
ONLY TO BE FILLED OUT WHEN STICKERS RECEIVED:
Permit Sticker(s) Received by: ______________________________ x ______________________________
Prorated Annual Fee: Total Fee Amount:
Issue Date: Expiry Date Issued By
