HomeMy WebLinkAboutSign Permit 00-008
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Whitl' - ^pplicant
Ye\I<iw - City
City of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No.~~
DIRECTIONS: Spaces Ilumbered 1 thru 10 must be filled in before permit is issued
(Please print or type, and sign where n'quired
t. PARCEL NO. OF PROPERTY:
~~
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3. OWNER: (NAME)
(ADDRESS)
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, '\'V\'""V ~ I
(ADDRESS)
~o...A ~ JUE (PHONE) tbe.-"4'1
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(PHONE)
2. APPLICANT: (NAME)
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4. SITE ADDRESS OR LOCATION OF SIGN
.5:t_SE-.-----L/4'J- 219J.e._
(PHONE)
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5. TYPE OF SIGN: TEMPORARY (21 DAY MAX/MUM DTSPLAY) PERMANENT<lEiiJ)MARQUEE/AWN/NG/FREESTANDTNG)
1/1111111111 * [/lI1lJ//'/" */lII.\'illl',\',\' *C//IIII!:eahle CliP.\' Sil:"'\' *Comtrt/ction Si!:IIS*'......,~,*/nstitlltional Siwrs*lArke Serl.ice Signs *
Mllltip/e R,..\'idelltill/ NlI1ll1'p/lltl' Siglls*OIl-P/"l'mi,~e Directillllal Siglls*Permanellt WindllIV Sign*Portahle Sign*SIII){1il'i~iOlr/dentificatioll Signs
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6. SIGN DIMENSIONS
(square feet) (lleight)
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(Depth)
In. Estimatcd Valuc of Sign
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11. Complction Datc
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7. TYPE OF CONSTRUCTION
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8. PROPOSED DISPLAY DATES (if applicable)
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE
0,
J hereby cel1ify that I havc furnished in!lJl"ll1ation on this application which is, to the best of my knowledge, true and correct I als~ certify that I am the owner
or authorizcd agent tl)[ the ahove-mentioned property, and t!la; c.;; construction will conform to all existing state and local laws and will proceed in accordance
with submitted plans. I am aware that the C~'tZ2Y Pial'. can revoke this permit for just cause. Furthermore. I hereby agree that City Officials or a designee
thereof" may enter upon the propert)' to performne . ed^ :spections.,.." _ _
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SJCiNAI'tJRF OF PROPERTY OWNER/AGENT DATE
FOR ^lHvllNISTR.\TIVllJSF
SUBMISSION REQUIREMENTS
___~nPleted ^pplication
'--:~~a1c Drawing showing location of sign
VPlans and Spefi,d.'
~j::::~'-(.;rmit Fcc $ --a z.... (Permit fee is set
at time of" application according to approved schedule)
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This Application becomes your Sign Permit when approved.
Date 3.":.L3--:.eD....
This is to certil'y that thc rcquest in thc abovc application and accompanying documents is in accordance with the City Sign Ordinance and may proceed as
rcqucstcd, This docnlllcnt. whcn signcd hy thc City .,anner or designce constitutes a temporary Certificate of Zoning compliance and allows construction to
commcncc.
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24 Ilollr Notice for ^1l1nspections
4,17-4230 trom 9:0() a,m. - 10:00 ;un.
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DATE: ~ c:l-)- tJC TITLE; X ~ - O. \.
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A. SEll' Jl'(S'I'ALLA nON: J J
I wn.x. aa...-mLE t'BE INSTALLATION A ALL THE lNSTA.LLATION .
UQtTIllE~tS, \VBIClt XNCLtTDES ANY & ALL PERMITS REQ1JIRED,
wrm MY OWN CONTRACTOR.. I ACCJ:.PT LOOTED W ~s &;
ACKNOWLEDGE THAT IT IS MY RESPONSIBILITY lOR rILING ANY
NECESSARY FREIGHT DA.lWAGI CLAIMS.
NAPA :oISTRIBtmON CEm'D: _, S"'2.. . nOli Ii
1. ctTSTOMER APPROV nD Qt101'EJ) PRODUCtS:
ltTBCllASlI ORDIR# ~ (ISSUED BY DC)
oil" N up".
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SIGNAn-m::
PATE. _
SHIPPING ADDRESS:
TITU:
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CONTACT PERSON:
PHom;: FAX:
.. I WO'O'LD I.IIa: to PURcEASE TD OPTIONAL SELF INSTALL
EXTL~IJ) W A.lUlAN'I1:"
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B, FADU\lJONT INSTALLATION:
., .A.I:DJONT SIGN COMP A...'VY IS TO COMPLETELY RANDLE TRE
INSTALLATION OF MY mELINI PLUS SlGNAGI. TBlS ~CLtTD!S ALL
EXTDiD:ED WA.RRA.N1IES &: WILL BE COMPLETE]) FOR TD FIDD
PRICE SnM.ITTED wrrBIN.TBE QUOTE ATl'ACBED. PERMIT COSTS,
ACQtTISmON "A;."'1Y SPECIALTY m~IS, SUCBAS STAn: ENG~1UNG
SlALED DP.A. WINGS A ZONING JlOA:RD OF APPEAL FEES. AJU:
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u ~x. CASU. !LI:Cnu~~ C'11tCtT~ a ~ONnC110NS AJU: 'TO Bit cgJ)'rrL!T!D BY '1'RE
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CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE, MN 55372
(612) 447-4230, FAX (612) 447-4245
RECEIPT # 36188
DATE: 3-/4-cD
ReceivedO~~V\
the sum of _~ ~~
for the purpose of
dollars
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Invoice #
$
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CROSSTOWN SIGNS, INC.
10166 HWY. 65 NE 612-784-7742
BLAINE, MN 55434
7899 ii
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$ lOlf~
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DOLLARS 1lIiE.'::" I
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75-5743
919
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DATE 0-9-00
~ Villag ank
~ ~ntraJ Ave.. NE. . Blaine, Minnesota 55434
FOR t/vT ',:,
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