Rev 12/2010
PAGE II Bensalem Township Application for Sign Permit
Permit #
OVERHEAD &
BANNER SIGNS
The applicant assumes full responsibility for erecting, maintaining and removing the banner
or sign and all liability for damages occurring to any persons or property resulting from any
act or omission associated with the banner or sign.
Sign Banner
(Authorized Signature Assuming Responsibility)
Message on sign or banner:
State Route:
Segment: Offset: Size (length & width):
Vertical Clearance Above Roadway (minimum 17’5”):
Install Date:
Remove Date:
ADDITIONAL
INFORMATION
• All requested information is required to be filed at the time of application.
• Incomplete applications will not be processed.
• All new signs require a building permit.
• Sub-division and development signs shall not be erected more than 60 days prior to start
of construction and shall be removed when construction is complete.
Promotional, special event, seasonal sales, etc. signs may be erected for a period not to
exceed 15 days and require Zoning Officer approval.
PLAN
REQUIREMENTS
Two copies of detailed plans and specifications for the proposed sign must accompany this
application. These must be signed and sealed by a PA licensed architect or engineer.
These plans must detail existing conditions on the site including existing signs, buildings,
parking areas, driveways, streets and all ultimate rights-of-way. Also include the location of the
nearest freestanding, roof, fascia, projecting or outdoor advertising (BILLBOARD) signs to the
proposed sign.
• Wall Sign – the dimensions of the wall surface of the building to which it will be attached
and the location where sign will be attached.
• Free-Standing Sign – the setbacks from property lines, buildings, driveways and edge of
improved road or curb (shown on a plot plan). A plot plan, signed and sealed by a PA
licensed architect or engineer is required.
• Outdoor Advertising Billboard – designate double or single face design as well as a
description of the plant material to be planted adjacent to the sign as required by ordinance.
• The materials, finish, and the construction including loads (wind & seismic), stresses,
anchorage, any illumination, and the fail-safe provisions for animated devices (if any).
Contact
Information
Property Owner’s Name
(type or print)
Applicant’s Signature
(if other than owner)
Contractor
(if other than Applicant)
Name
Address
Phone
License #
APPROVALS
FOR B&P USE ONLY
Check #
Amount: $
UCC-5
Township of Bensalem Dept. of Building & Planning
A SIGNED COPY OF THIS APPLICATION IS REQUIRED PRIOR TO ISSUANCE OF PERMIT
