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2. SIGN PERMIT APPLICATION
4. Owner Information
6. First Name
7. Last Name
9. Address
11. Phone Number
12. Date
14. ** In the case of lease agreement, a copy of the lease agreement must be attached to the permit application**
16. Contractor Information
18. First Name
19. Last Name
21. Business Name
23. Address
24. Phone Number
26. ** Every sign contractor shall provide proof of certificate of liability to indemnify the City of Moss Point against any form of liability to a minimum of one hundred thousand dollars($100,000.00), OR shall be responsible through any agency or subcontractor.**
28. Sign Information
30. Address or Map Parcel No. of Sign Site
32. Zoning District( Check one that applies)

    1. R-1
    2. R-2
    3. R-3

    1. R-4
    2. C-1

    1. C-2
    2. C-3

    1. C-4
    2. Industrial
34. Type of Sign
    i.e.( Temporary, Monument, Projecting, etc.)
36. Total Valuation $
38. ** Please attach a clear and legible drawing with description and nominal dimension, showing location of the sign which is the subject of the permit, and all other existing signs are on the premises.**
40. Contractor or Owner's Signature
41. Date
43. Building Official Signature
44. Fee $
46. For more information on the City of Moss Point Sign Ordinance please visit www.cityofmosspoint.org
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48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

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