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SOUTH DAKOTA DEPARTMENT OF TRANSPORTATION

OUTDOOR ADVERTISING PERMIT APPLICATION


SIGN OWNER



LOCATION OF SIGN
SIGN LOCATION (CHECK ONE)



(IN FEET)


(IN FEET)


(NAME AND ADDRESS)

IF APPLICABLE PLEASE ATTACH LANDOWNER ACKNOWLEDGEMENT OF LEASE



LANDOWNER NAME (PRINTED) LANDOWNER SIGNATURE DATE
SIGN FEATURES
SIGN STYLE


TYPE OF CONSTRUCTION

LIGHTED
SKETCH AND DIMENSIONS










I CERTIFY THAT ALL STATEMENTS ARE TRUE AND COMPLETE, WITH THE SAME FORCE AND EFFECT AS THOUGH GIVEN UNDER OATH AND HEREWITH ACCEPT THE TERMS AND CONDITIONS OF SDCL 31-29, HIGHWAY BEAUTIFICATION AND REGULATION OF ADVERTISING, AND AGREE TO FULLY COMPLY THEREWITH.

I UNDERSTAND THAT ACCORDING TO STATE LAW, EFFECTIVE JULY 1, 1985, A PERMIT AND FEES ARE REQUIRED FOR OUTDOOR ADVERTISING SIGNS AND THAT FAILURE TO OBTAIN THE PERMIT AND PAY THE ANNUAL FEE WILL REQUIRE THE STATE TO CAUSE REMOVAL OF THE SIGN.

I AGREE TO ERECT THE SIGN WITHIN 90 DAYS OF APPROVAL OF THIS PERMIT AND FAILURE TO COMPLY WILL INVALIDATE THIS PERMIT.



SIGNOWNER NAME (PRINTED) SIGNOWNER SIGNATURE DATE

RETURN ORIGINAL COPY TO THE REGION OFFICE FOR REVIEW
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
FOR DEPARTMENT OF TRANSPORTATION USE
REGION
HIGHWAY NO.
OWNER CODE
MRM
FEE AMOUNT
SIGN SIZE
DATE FEE RECEIVED
TOTAL FACE AREA (SQ. FT.)
REMARKS



ZONING - ZC - UA
- ZI - UZ
- OZ - UC OR UI


REGION BEAUTIFICATION AGENTREVIEWED

PERMIT IS DISAPPROVED AS SIGN DOES NOT MEET ALL CRITERIA OF SDCL 31-29
PERMIT IS APPROVED FOR THIS SIGN WHICH IS CLASSIFIED AS A NONCONFORMING ADVERTISING DEVICE ON THIS DATE.
PERMIT IS APPROVED FOR THIS SIGN WHICH IS CLASSIFIED AS A CONFORMING ADVERTISING DEVICE ON THIS DATE.


DIVISION OF OPERATIONS APPROVED DISAPPROVED

DISTRIBUTION AFTER ACTION: ORIGINAL – CENTRAL OFFICE COPY – REGION OFFICE COPY - SIGNOWNER

INSTRUCTIONS


Fill out this form online, click print at the top and mail when finished.
An application is needed only for an “off-premise” advertising sign.

SIGNOWNER - Give complete name and address.

TELEPHONE NUMBER - Give area code and number.

LOCATION OF SIGN
County - Give name of the county the sign is located in.

Highway No. - Give number for the highway the sign is on.

Mileage Marker - Markers giving mileage designations are located along the highway shoulder. The mileage on these markers increases when traveling east or north. Measure the distance to the nearest 1/10 mile from a marker to the sign and add or subtract to determine the sign location.

Sign Located On - Mark the box for the side of the highway the sign is located on.

Distance From Sign Edge To ROW - Measure the distance to the nearest foot between the highway right-of-way and the nearest edge of the sign face.

Distance To Nearest Sign - Measure the distance to the nearest foot, parallel with the highway, from your sign and the nearest sign on the same side of the road. If the distance is more than 500 feet, enter “500+”.

Legal Description Of Land Sign Is To Be Located On - Be specific by giving lot, tract or portion of the section along with the section, township and range numbers.

Property Owner - Obtain landowner signature along with complete name and address.

Telephone Number - Give area code and the number.

SIGN FEATURES
Sign Style - Mark the box that best describes the style of sign.

Type Of Construction - Mark the box that describes what the sign face is made of.

Lighted - Mark whether or not the sign face is lighted.

Sketch and Dimensions - Draw an accurate sketch of what the sign face looks like and provide sufficient dimensions to the outside of any border or trim for use in computing the total face area. Odd shaped portions may be shown and dimensioned as approximate geometric shapes such as circles, triangles, etc.

PERMIT FEE - Attach the fee for the size of the sign face as per the following schedule:
0 to 100 sq. ft. - $16
101 to 300 sq. ft. - $24
301 to 500 sq. ft. - $32
501 to 700 sq. ft. - $40
701 to 900 sq. ft. - $48
901 to 1100 sq. ft. - $64
Over 1100 sq. ft. - $72

Upon completion of the above items, date and sign the application. The completed application and the required fee payment are to be submitted to one of the following offices:

Department of Transportation
PO Box 1767
Aberdeen, SD 57401-1767
Phone (605)626-2244
Department of Transportation
PO Box 1206
Mitchell, SD 57301-7206
Phone (605)995-8129
Department of Transportation
104 S. Garfield
Pierre, SD 57501-5405
Phone (605)773-3464
Department of Transportation
PO Box 1970
Rapid City, SD 57709-1970
Phone (605)394-2244