HomeMy WebLinkAboutSign Permit 00-01
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City of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. t9:9 -D (
DIRECTIONS: One completed application per sign is required. Applicant is
responsible for obtaining a building permit ifnecessary.
1. PARCEL I.D. OF PROPERTY:
Le
(ADDRESS)
~V'-t .JL
4. SITE ADDRESS OR LOCATION OF SIGN
4770
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(PHONE)
4<-17- 'S bblA
(PHONE)
2. APPLICANT:
(NAME)
L e_/J
(NAME)
(ADDRESS)
3. OWNER:
(PHONE)
5. TYPE OF SIGN: PERMANENT (WALLlMA.RQUEElA WNING/FREESTANDING)
BaUoon* Banner*Busi Si ns*Constru . uminated Signs*Instihltional Signs*Lake Service Signs*
Multiple Residential Namepllzte Signs*On-Premise Directional Signs*Permanent Window Sign*Portllble Sign*Subdivision ldentijictztion Signs
6. SIGN DIMENSIONS
(square feet)
10. Estimated Value of Sign
(Height)
2 'f-
7. TYPE OF CONSTRUCTION
(Width) (Depth)
~1f-
11. Completion Date
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I hereby certify that I have furnished infonnation on this application which is, to the best ofmy Imowledge, 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 the City Planner can revoke this permit for just cause. Furthermore, I hereby agree that City Officials or a designee
thereof may enter upon the property to perform nee ztions.
SIG
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FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
/' Completed Application
~cale Drawing showing location of sign
V Plans and spec),
Permit Fee $ ~ ~ (permit fee is set
at time of application according to approved schedule)
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Permit when approved.
By
Date },~. l~ .6'D
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.
Special Conditions <\ ~~ ~ 1t~ ~~ .~ b-l c- fD".
24 Hour Notice for All Inspections
447-4230 from 9:00 a.m. - 10:00 a.m.
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RECEIPT
DATE 1.{)!J-tfJo
CITY OF
PRIOR LAKE
16200 Eagle Creek Avenue S.E.
Prior Lake, MN 55372
DEPARTMENT:
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Received of ~ Le.... ~
The sum of Ii::;' ~
For the purpose of ~ ~. ~"'~ ~~~
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dollars
$ l~~
Account #
Receipt Clerk for the Ci~ake
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FONGS CHINESE CUISINE
4770 PLEASANT ST., SE, #3
PRIOR LAKE, MN 55372
6616
DATE~ 75-16372
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