HomeMy WebLinkAboutSign Permit 98-156
City of Prior Lake
APPLICATION FOR SIGN PERMIT
PYi
Permit No. r8.~ 15 (p
DIRECTIONS: One completed application per sign is required. Applicant is
responsible for obtaining a building permit if necessary.
1. PARCEL I.D. OF PROPERTY:
2. APPLICANT: (NAME)
~ttk./Yj Ou1/~T / S~7S-1Y4A/1(///V7i-L SF ~llJtf
3. OWNER: (NAME) (ADDRESS)
J I r -r: J.. j /) -+- Pt}, .sox f 6 -1
nB:J..I TEi<- ocue-w/lj" I h1;f(-P ro. y / IlI~Y5i-f1 P J3;4 Y;Cb r1> ;WtJ 55003
4. SITE ADDRESS OR LOCATION OF SIGN I
SA Yne. 0- S' /?8o Vc 0/1/ BUJ/ d/Nf
(ADDRESS)
d'S -Cf3&-oo
(PHONE)
-0
(PHONE)
(6Sj)Lj30-0163
(PHONE)
5. TYPE OF SIGN: TEMPORARY (21 DAY MAXIMUM DISPLAY) PERMANENT (WALl/MARQUEE/AWNING/FREESTANDING)
BaUoon* Banner*Business*Changeable Copy Signs*Construction Signs*muminated Signs*Institutional Signs*Lake Service Signs *
Multiple Residential Nameplate Signs*On-Premise Directional Signs*Permanent Window Sign*Portable Sign*Subdivision Identification Signs
6. SIGN DIMENSIONS
(square feet)
/ / /rr
7. TYPE OF CONSTRUCTION
mo/jep jJMJj;~ L ~ -t7e y.}
8. PROPOSED DISPLAY DATES (if applicable)
(Height)
(Width)
//~r
(Depth)
2 /1
10. Estimated Value of Sign
.r 22 S-
11. Completion Date
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE
I hereby certify that I have furnished infonnation on this application which is, to the best of my knowledge, true and correct. I also certify that I am the owner
or authorized agent for the above-mentioned property, and that all construction will conform to all existing state and local laws and will proceed in accordance
with submitted plans. I am aware that th . anner can revo e this permit for just cause. Furthermore, I hereby agree that City Officials or a designee
thereof may enter upon the property to orm ne ded inspe ti s.
FOR ADMINISTRATIVE USE
/14;);,1
DATE
SUBMISSION REQUIREMENTS
~1"",, Appli,,"oo
_ Ie Drawing showing location of sign
lans and Specs () tl iJ
_ Permit Fee $ 3 (permit fee is set
at time ofapplication according to approved schedule)
NOV
3 Iq9S
This Application become;.rJur Si n Permit when approved.
By Y/}. ~
City Planner or designee
It/q/tt Y
This is to certify that the request in the above application and accompanying documents is in accordance with the City Sign Ordinance and may proceed as
requested. This document, when signed by the City Planner or designee constitutes compliance with the Sign Ordinance.
Date
Special Conditions
24 Hour Notice for All Inspections
447-4230 from 9:00 a.m. - 10:00 a.m.
l:\handouts\signform.doc
(
~~----_.~~._._~._---_._-~
Received of
the sum of
for the purpose of
CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE, MN 55372
(612) 447-4230, (612) 447-4245
RECEIPT# 33744
DATE: 11-11-'1~
dollars
$
~
I
BUILDING PERMIT #
BUILDING PERMIT #
1,200.00
700.00
1,500.00
Building Permit Fee
Plan Check Fee
State Surcharge
Park Support Fee
SAC
Plmb Pmt pp#
Mech Pmt mc#
Mech Pmt mc#
Swr/Wtr Pmt sw#
Pressure Reducer
Water Meter
Tree Preservation Deposit
Swr/Wtr Connection Fee
Water Tower Fee
Builder's Deposit
Other
Total
Building Permit Fee
Plan Check Fee
State Surcharge
Plmb Pmt pp#
Mech Pmt mc#
(Heating only - $65.00)
(Htg & Air - $100.00)
(Fireplace - $40.00)
(Air - $40.00)
Swr/Wtr Pmt sw #
Other
Total
HECHTER GATEWAY
LIMITED PARTNERSHIP
P.O. BOX 167 PH. 430-0163
BAYPORT, MN 55003
75-511/919
217869
3264
DATE
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$ 60 N;'0
PAY TO THE ~ a L IL
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Bank
2270 Fronc.ge Road West. Stillwater, MN 55082
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