HomeMy WebLinkAboutApplication for Outdoor Advertising Permits
FORM 575-070-04
RIGHT OF WAY
OGC - 1 1/99
PAGE 3 of 3
FLORIDA DEPARTMENT OF TRANSPORTATION
RE: Application for outdoor advertising sign permit
To be completed by applicant:
Name of Applicant or Company: MEDIANET, INC.
Sign is: existing X_ proposed
County: ST. LUCIE Municipality, if applicable: N/A
Highway Name and Number: FLORID& TURNPIKE S.R. 91
Sign location description: NORTH SIDE OF TURNPIKE 9 MILE NORTH OF OKEECHOBEE RD.
ParcellD#: 1226-333-0001-000/7
To be completed by appropriate zoning official:
Designation of parcel on the Future Land Use Map:
Does this designation allow for commercial or industrial type uses, other than outdoor advertising, on the parcel?
Yes -Z No
Current Zoning of parcel (from Land Development Regulations): IV - S
Does this designation allow for multiple primary uses on the parcel?
✓ Yes No
Does this designation allow for outdoor advertising on the parcel?
✓ Yes No
Does this design n allow for commercial or industrial type uses, other than outdoor advertising, on the parcel?
Yes No
I certify that I am auth ized to sign this form on behalf of the county/municipality named above:
A" u' L� c&-VL /0 - ao - ao
Si ture of Local Government Official Date
Printed Name and Title
Local Government Permission: Please complete the items below. You may submit another form of written statement
indicating that the sign complies with all local governmental requirements. For a proposed sign location, a copy of the building
permit issued by the local government may be submitted.
The outdoor advertising sign identified in this application:
is in compliance with all duly adopted local ordinances and has been or will be issued the necessary permits.
_ is not in compliance with local ordinances, but is legally existing as a non -conforming sign.
_ is not in co liancewjth local ordinances and is/would be considered to be an illegally maintained structure.
Signature of Local dovernment Official Date
�Oa%if'4 WArks ,6 /--
Printed Name and Title
RECYCLED PAPER 0
FORM 575470-04
p RIGHT OF WAY
0 f L�� OGC • 11199
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION PAGE 1 OF 3
APPLICATION FOR OUTDOOR ADVERTISING PERMIT
(A) APPLICANT INFORMATION: (If you currently hold a State of Florida outdoor advertising license or permits, please enter the name, address and account
number on file with the Department.) PLEASE TYPE OR FILL OUT IN INK. APPLICATIONS SUBMITTED IN PENCIL WILL BE RETURNED. For assistance In
completing this form, please call (850) 414.4545.
1. Name of Applicant or Company: MEDIANET, INC.
2. FDOT Account Number: VF593468951001
If new account, Federal Tax ID #- Or Social Security #_ N/A
3. Address of record (for billing purposes and legal notices): P • 0 . BOX 2001
City/State/ZipCode: MINNEOLA FLORIDA 34755
4. Mailing address for permit lag (if different from above): S AME AS ABOVE
(BI LOCATION INFORMATION:
1. Court ST. LUCIE
ry• Property tax to#: - 2 6 3"3 3`,- Q�0 01 �
3. X Proposed Location -- FLORIDA
_ Existing sign: Is located on: State Road #: 91 US Route III: N/A Local name & Number: TURNP I K E
9
omiles o feet NORTH of OKEECHOBEE ROAD
facing
EAST �� Nearest ntersec on
(N.E.S.W.)
Sign will be/Is on the N side of the highway,
ff n—N.)
4. Distance of closest part of sign to edge of right of way: 2 5 FEET
5. Name of existing business within 800' and on same side of highway as sign location: 1. N/A
Names of 2 other businesses within 1600' of business named above. 2. N/A 3. N/A
Distances of businesses from each -other. 1.2 N/A 2-3 N/A 3-1 N/A
6. Do you own or LE AS E lease site? If lease, name of landowner:_ OLC r INC.
7. Method of marking location: L Stake/flag !Painted pavement —Other (describe) SEE PHOTO
(C) SIGN DESCRIPTION:
1. Facing height: 10 1— 6 11 Facing width: 3 6 1 Total S Ft.: 378
q• 2. Changeable facing? _Yes X No
3. Height Above Ground Level: l
6 4. Sign structure Height: 5 0 a 5. # of poles: 1
6. Material used for: Sign facing: METAL Supports: METAL
7. Configuration of sign: X{ V-shape _ Back -to -Back _ Side -by -side _ Single faced
8. Will sign be lighted? XYes _ No If yes, describe lighting: 400 WATT HOLOPHANE FIXTURES ON CATWALK
9. Will cutting or trimming of vegetation on State right of way be required to create a viewing zone for this sign? Yes X No
If the answer is 'Yes,' a Management Plan must be approved by the Department and the permits for two nonconforming signs cancelled.
Permit tag numbers to be cancelled: N/A 0
10. Is an existing permit being cancelled as a condition of Issu nce f t s perm t other than for ve etatlon management? —Yes 2L No
If yes, permit tag number to be cancelled: N/A
NOTE: IF A PERMIT IS BEING CANCELLED FOR EITHER 15. C J 16., I CANC LLATION CERTIFICATION TO THE DISTRICT OFFICE
WITH THIS PERMIT APPLICATION. IF THE NEW APPLICATIOr IS NOT APPROVED, THE PERMIT S) WILL NOT BE CANCELLED.
XREQUIRED ATTACHMENTS (Application will be returned as Inco � plet Ire e n submitted with the application- see Instructions)
L""o"er &ro=uon: X Locabcn Sketch: XLcoal Govemrnenl Zorinp4.and use • �453T�
�v mervmgs (Per (els) and surrounding vegetation:.XAppocation fee. PLEASE NOTE: M you do not oxrantly, hold an Outdoor org Ljoe ant; m Photograph of air
you to ocoih we Delon a A avert sng License, B maybe nacessaty for
permit �n be issued,
NOTARIZATION AND CERTIFICATION
1. L"U,41 MIJ L . l:t1U14s%ISby certify that the information given and the armaments made in this application are true and that I have received, in writing, permission from the
landowner or other person in lawful possession of the site to erect an outdoor advertising sign at the location designated in the application. I understand that submission of false or misleading
information on this application, or any other violation of Chapter 479. Florida Statutes, or Chapter 14.10, F.A.C., may result in revocation orthis permit. I further understand that the metal permit
tap muA be posed at thcnp site within 30 days o 'ssuancc ad th completed sign as described in this application must be built within270 days ofpormit issuance or this permit is VOID.
1 ... ,....PRESIDENT
gnatur
Swom a
(Names
State of
S,inatui
APP
FORM 575-070-04
RIGHT OF WAY
OGC • 11199
PAGE 2 OF 3
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
APPLICATION FOR OUTDOOR ADVERTISING PERMIT
(THIS PAGE FOR DEPARTMENT OF TRANSPORT ATIO N USE ONLY) -7O
l,/ �' ODAIMS Application #: � 1 ,
11. Applicant: E
By:
12. Dateltime re 'd by District: w ,� No
13. Is application being submitted as result of a notice of violation? 99 — Yes O /S
If yes, Notice # and DOT Case #, if applicable: No
14. Are existing permits being cancelled: _•Yes
No For vegetation management? Yes
Current tag #(s):
(If yes, applicant must submit Cancellation Certification to the District office with this permit application.)
Secondary (SHS)
a j r% U�' / 1 162 Type highway: Interstate
15. State road #: Yes
16. Urban area? Yes 17. Incorporated?YNo 18• Within city? � No
No
19, Land Use: Zoned comm.find. __
Unzoned commAnd. —4q-- Other A
2 3.
If unzoned, name of three businesses: 1. 3-1
Distances of businesses from each other: 1-2
2-3
LOCATION INFORMATION
��� _ County number. �� u
County name: s) Milepost:
n•[l u' �/"Y^�� Direction:
RCI Section: WR RHR Par 1
(�• �{ f Sign read:
Side of section: Q / lttil Direction:
a, Distance from feature: _
RCI reference feature: -
- Date location inspected: ) �
20. Inspector's name: Sv f
21. Distance from nearest permitted location (same side of highway):
SIGN INFORMATION �� [
Facing height: Z19
Facing width:
HAGL:
Is sign being permitted as nonconforming: ,z Yes No
Signature of ODA Admi
Structure height (above crown of road): G1
Distance off RIK ) 6
_ Intent to Permit (Veg.Mgmt.)
Date,.
Date: [ 2 -- T cJV
For FDOT Central Office Use Only: Structure #:
Date reed from District:: -Z::,. —DD Facing #: ,.
(o93�j Date-entered-ODA-IMS:
Rec't Number._ . - ---.� �_ C v1-
Certified Mail #: q66� D&O b O � 5 D 9 Go�3 y- / _ e, /
EI
I
FORM 57"7004
„O 0 �, r !� RIGHT OF WAY
;
�'C! y y OGC • 1 lH9
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION PAGE 1 OF 3
APPLICATION FOR OUTDOOR ADVERTISING PERMrr
(A) APPLICANT INFORMATION: (If you currently hold a State of Florida outdoor advertising license or permits, please enter the name, address and account
number on rile with the Department.) PLEASE TYPE OR FILL OUT IN INK. APPLICATIONS SUBMITTED IN PENCIL WILL BE RETURNED. For assistance in
completing this form, please call (850) 414-4545.
t. Name of Applicant or Company: MEDIANET y INC.
2. FOOT Account Number: VF 5 9 3 4 6 8 9-510 O 1
If new account, Federal Tax ID #_ N/A Or Social Security # N/A
3. Address of record (for billing purposes and legal notices): P - 0 - BOX 2001
City/State/ZipCode: MINNEOLA, FLORIDA 3475.5
4. Mailing address for permit lag (if different from above): S AME AS ABOVE
[B) LOCATION INFORMATION:
i. County: ST . LUC I E 2 Property Tax.ID#: 1Zr2�6t,u�3 3.'3, �OQQ.,1=00-0%'7 J
3. X Proposed Location --------FLORIDA
_ Existing sign: Is located on: State Road #: 91 US Route #: N/A Local name & Number: TURNP I K E
9 Xmiies o feet NORTH of OKEECHOBEE ROAD Sign will bells on the N side of the highway, (p
WEST Nearest ntersecton W-)
racing (N.E.S.W.) 4. Distance of closest part of Sign to edge of right of way: 25 FEET
5. Name of existing business within 800' and on same side of highway as sign location: 1. N/A
Names of 2 other businesses within 1600' of business named above. 2. N/A 3, N/A
Distances of businesses from each other: 1-2 N/A 2.3 N/A 3-1 N/A
6. Do you own or LE AS E lease site? If lease, name of landowner: OLC f INC.
7. Method of marking location: L Stake/flag X{ Painted pavement _Other (describe) SEE PHOTO
(C) SIGN DESCRIPTION:
1. Facing height: 10 1 — 6 11 Facing width: 361 Total Sq.Ft.: 378 2. Changeable facing? Yes X No
3. Height Above Ground Level: 1
6 a. Sign structure Height: 5 0 1 S. # or poles: 1
6. Material used for: Sign facing: METAL Supports: METAL
X
7, Configuration of sign: _ V-shape _ Back -to -Back _ Side-by-slde _ Single faced
8. Will sign be lighted? XYes _No If yes, describe lighting: 400 WATT HOLOPHANE FIXTURES ON CATWALK
g. Will cutting or trimming of vegetation on State right of way be required to create a viewing zone for this sign? _ Yes X No
If the answer is 'Yes,' a Management Plan must be approved by the Department and:the_ permits for.two nonconforming signs cancelled.
Permit tag numbers to be cancelled: N/A
10. Is an existing permit being cancelled as a condlllon of Issuance of this permit other than for vegetation management? _Yes —X_No
If yes, permit lag number to be cancelled: N/A nt�rF�
NOTE: IF A PERMIT IS BEING CANCELLED FOR EITHER 1
WITH THIS PERMIT APPLICATION. IF THE NEW APPLICA
R;8WE3tG P"rei1`CA ELLATION CERTIFICATION TO THE DISTRICT OFFICE
PROVED, THE PER T(S) WILL NOT BE CANCELLED.
REQUIRED ATTACHMENTS (Application will be returned as Inc mplet (r� 1r� 2taj"ts are of submitted with the application- see Instructions)
p tan0owner Autr,ortiatior>; X Loca6an Sxakh; XLocaI GoverrmwI Z*jrVLarid Ua V . `Govttrtvrtxtl bu0d4p of eptJvtdenl' X Photograph of aib
vvawv,g manungs 1— I5)6) and surrounding vegetation: XAppGcation fee. PLEASE OTE: If you do nd txrrontly hold en Outdoor License. 8 may be ns��,y for
you a olxait one Datore a permit can be issued. PERMITS
IDI' NOTARIZATION AND CERTIFICATION D1ST•
1. DANI EL L . CHOLAJ�y cenify that the information given and the statements made In this application are true and that I have received, In writing.
landowner or other person in lawful g permission from the
Possession of the site to crest an outdoor advertising sign at the location designated in the application, 1 understand that submission of fa4e or misleading
mrormstion on this applicnion, or any other. violation orChapter 479, Florida Statutes, or Chapter 14.10, F.A.C., may result in revocation of this>permit. I further understand that the metal permit
tag must Oc posted at the sign site within 30 days o ' suance and the completed sign as described in this application must be built within 270 days orpermit issuance or this permit is VOID.
PRESIDENT
Si at rc of apphcsni Position in Company, If applicable
Swore and subscribed before me this X day or rrr/���lnl�p ylBy F_.,3 -s lt�
tNsme of aRiany.RS/Isc is personally known to me or has produced C
State of Q IACn t / v
5 ignsture of No `( \ �� � My Commission Expires:
Notary's Printed Name:
UPON APPROVAL, THIS APPLICATION BECOMES THE PERMIT FO
KELLIE IVEY
MY COMMISSION q CC 800131
EXPIRES: January 3, 2003
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
APPLICATION FOR OUTDOOR ADVERTISING PERMIT
(THIS PAGE FOR DEPARTMENT OF TRANSPORTATION USE ONLY)
11, Applicant:���"'�/A YE/ i�y� ODAIMS Application #:_5 7l D
12. Date/time rec'd by District: __X% Af 2
13. Is application being submitted as result of a notice of violation? Yes X No
If yes, Notice # and DOT Case #, if applicable: 22— 0 .2/ S
14. Are existing permits being cancelled: _ Yes X No For vegetation management? _ Yes No
Current tag #(s):
(If yes, applicant must submit Cancellation Certification to the District office with this permit application.)
15. State road #:-SIR 9 f ' UP) K/_ Type highway: Interstate FAP _�L Secondary (SHS)
16. Urban area? —Yes 17. Incorporated? _ Yes 18. Within city? Yes
-� No � No
No
19. Land Use: Zoned comm.Md. Unzoned commend. _� Other AC- "5
If unzoned, name of three businesses: 1. 2. 3.
Distances of businesses from each other. 1-2 2-3
3-1
LOCATION INFORMATION
County name: !;;r Lkxel 5-- County number. 4/14 �1 lJ
RCI Section: ClyY 2 rt;tz Direction: % 1l2;W Milepost:
Side of section: Rf Get Sign read: _- (_ LHR RHR Par
RCI reference feature: 1Ajjf.J6 Distance from feature: ()- /Q5 ,tA/. Direction: _ ()U l 14
20. Inspector's name: 2z- T Date location Inspected:
21. Distance from nearest permitted location (same side of highway): I SLED °f'
SIGN INFORMATION
Facing height: /a ' t,Facing width:
HAGL: �61
Is sign being permitted as nonconforming: _�L Yes _ No
Structure height (above crown of road): .61
Distance off RNV: a
gppI'+"cat ._jVr @ A pr, o � `fi Denied Intent to Permit (Veg.Mgmt.)
Signature of Inspector: \ Date:
Date: rZ -ZCI - CJo
Signature of ODA Administrator, l
Central Office approval: Date: /27�--S�Oi7
"-�.^ j., 1 G . r :O �h.�s' }5+ •`vs' ry o. ��.''S': b4 v �y.�`s �J �,,".,r S,r'.c,. a
For. FDOT.,Dfstrlct Usa Only a .,i�Qs < ;.
For FDOT Central Office Use Only:
Date rec'd from District:: 0 Facing M Structure #:
Rec't Number. G 7 -39 V Date enter_el
'Datetta�11600 , • ' Tagt#.Ins e
Certified Mail t R 0 00 0(9OO D 0 a 1 ) 91fl G a b
FORM 575-070-04
RIGHT OF WAY
OGC•IIM
PAGE 2 OF 3
'D
m
X
K
r
— 0-8 By: 0-4