Date:
Permit Number:
Plan Check #:
Project Address: Zone:Lineal feet of frontage:
Name:
Address:
City/State/Zip:
Phone:
Fax:
E-Mail Address:
Project Contact:
Address:
City/State/Zip:
License Number:
Signature of Applicant:
Calculated Permit Fee:
Notes:
Authorized by:
Application Date:
Company Name:
Address:
City/State/Zip:
Sign Dimensions:
Total Square Feet:
Sign Description:
Phone:
Fax:
E-Mail Address:
License Type:
Phone:
Fax:
E-Mail Address:
The City of Galva may require written approval from the owner
City of Galva
311 N. W. 4th Avenue
Galva, IL 61434
Phone: (309) 932-2555
Fax: (309) 932-3306
www.galvail.gov
Sign Permit
Application
Property Owner
One - Sided
Electrical Required No Electrical Required
Two - Sided
Tenant
Page 1 of 1
Is this permit in conjunction with a building permit?
Yes No
Contractor/Builder/Electrician (if needed)
I herby certify that the proposed work is authorized by the owner of record and that I am the owner or have been authorized by the
owner to make this application as his authorized agent and that we agree to conform to all applicable laws of this jurisdiction.
Office Use Only
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