Louis Andersen
County Manager
COMMUNITY DEVELOPMENT
Planning Division
31 North Pinal Street, Building F, PO Box 2973, Florence, AZ 85132 T 520-866-6442 FREE 888-431-1311 F 520-866-6530
www.pinalcountyaz.gov
PINAL COUNTY COMMUNITY DEVELOPMENT
Outdoor Lighting Permit
(An MPE Application must be completed along with this application.)
Please submit the following items in addition to the requirements of your MPE Permit:
ATTACH 8.5”X 11” (or larger for clarity) SITE PLAN (DRAWN TO ENGR. SCALE) SHOWING PARCEL SIZE & DIMENSIONS,
SETBACKS, ANY EXISTING BLDGS., LOCATION EXISTING & PROPOSED LIGHTS.
ATTACH TECHNICAL SPECIFICATIONS OF PROPOSED LIGHTING INCLUDING MANUFACTURER’S CUT SHEETS &
SPECIFICATIONS, PHOTOMETRICS FOR BOTH TOTAL SITE LUMENS AND INDIVDUAL LIGHT OUTPUT
PROPOSED SHIELDING
COMPLETED ARENA WORKSHEET IF APPLICABLE
1) JOB STREET ADDRESS: ___________________________________________________________
2) ASSESSOR’S BOOK________ MAP_______ PARCEL_______ SIZE OF PARCEL ________
4) PROPERTY OWNER: ___________________________PHONE__________________________
ADDRESS: _______________________________CITY: _________________ST _____ ZIP ______
5) EXISTING BLDGS AND USES: ______________________________________________________
6) TYPE OF LIGHTING: LOW PRESSURE SODIUM _____ METAL HALIDE _____ QUARTZ _____FLOURESCENT___
FOSSIL FUEL ____LED_____INCANDESCENT ____SEARCHLIGHT ___OTHER (SPECIFY)_____________________
*Mercury Vapor Lights are prohibited in Pinal County and must be removed, please dispose in accordance with applicable law
7) HEIGHT OF LIGHTS ______TYPE OF SHIELDING ___________________TOTAL WATTAGE__________
TYPE OF FILTRATION____________________________________TOTAL LUMENS__________________
8) PURPOSE OF LIGHT (BE SPECIFIC): ___________________________________________________
9) SETBACKS: (INDICATE N, S, E,W AFTER EACH DISTANCE)
FRONT _________ LEFT SIDE _________ RIGHT SIDE _________ REAR _________
I hereby certify that this application and all submittals are true and correct.
_______________________________________________ _________________________________
SIGNATURE OF OWNER/APPLICANT DATE
OFFICE USE ONLY: INSPECTOR _______INV.#______________ ZONING _______ ZONING FEE ___________
MPE #__________________PER#_______________________
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