HomeMy WebLinkAboutSign Permit 00-009
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Yellow - City
City of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. __~::199~
DIRECTIONS: Spaces numbered 1 thru t () must be filled in before permit is issued
(Pleas(' print or type, and sign where required
1. PARCI<:L NO. OF PROPERTY:
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L V ""S~-r:Q1, ~~
3. OWNER: (NAME)
(ADDRESS)
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(ADDRESS)
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(PHONE)
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(PHONE)
2. APPLICANT: (NAME)
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4. SITE ADDRESS OR LOCATION OF SICN
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(PHONE)
5~T\~~ OFS~~~~(2J DA:::iEXIM~SPLAY)-PERMANENT~ARQUEE;AJf;NiNG/FREESTANDING)
Balloo1l * Ba1l1ler*Busi1les.\"*Cha1lgeable Cop)' Sig1ls*Co1lstructio1l Signs*lllllminated Signs*lnstitlltional Signs*Lake Service Signs *
Multiple Reside1ltial Nameplate Signs*On-Premise Directional Sig1ls*Permanent Window Sign*Portable Sign*Sllbdivisio1lldentijication Signs
1 . I
_________1.0_____ - . -----.--------~-----
7. TYPE OF CONSTRUCTION
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(Depth)
10. Estimated Value of Sign
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11. Completion Date
6. SIGN DIMENSIONS
(square feet) (Height)
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8. PROPOSED DISPLAY DATES (if applicable)
SIGN PERMITS WILL NOT BE PROCESSED IF. .~EY ARE INCOMPLETE
.,
1 hereby certify that I have fiJrnished in/ilflnalion on this application which is, to the best of my knowledge, true and corrcc! I also certify tbat I am the owner
or authorized agent It)r the above-mentioned property, and that all construction will conform to all existing slate and local laws and will procced in accordance
with sllbmitted plans I am aware that the City, a ner can revokc this permit for just callsc. Furthermore, I hercby agree that City Officials or a designee
thcrcoflllay ellter 111'011 the property to~erl(lT1 1I::::~~ ~ -J-"-t>~:.._
SIGNAn tl-: OF PROPERTY OWNER/AGENT DATE
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FOR ADMINISTRi\TIYI' IISF
SUBMISSION REQUIREMENTS
_~npletcd Application
---0calc Drawing showing location of sign
~ ~Ians and specSZ w
~rmit Fee $ () - (Permit fee is set
at time of application according to approved schedule)
Th;' ^PPIi<at:n~~h'n appm"d.
City Planne or designce
Dale 3 -I ~ Ic;()
This is to certify that the request in the abovc application and accompanying documents is in accordancc with thc City Sign Ordinance and may proceed as
requcsted. This doclIlllelll. whell siglled by the (.ity Planner or designee constitutes a tcmporary Certificate of Zoning compliance and allows construction to
commence.
Special Conditions._5~k~-L(e-~- ko___~IJs F0L~~~2Lb~_
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24 Ilour Notice for All I nspectiol1s
<147-4230 from 9:00 a.m. - !O:OO a.m,
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A. SELl ~TALLA nON: <f" j
I WILL RA..~LE THE INSTALLATION A ALL THE INSTA.LLATION . 1-/
REQ~TS, \VRtCH INCLUDES ANY & ALL PERMITS REQlJ1RED,
\\'111I MY OWN CONTRACTOR. I ACCUT LIN1TID W.A.DA.NTIES 8;
ACKNOWLEDGE l1IAT IT IS MY RESPONSIBILI'IY lOR rILIN'G ANY
NECESSARY FREIGHT DA1'WAGE CLAIMS.
NAP A DISTRIBt1TION CEm'ER.:. n STORE 1#
1. CUSTOMER Al'l'ROV. lD QUO'I"EX) PRODUCTS:
1trBCBASJ OlU)ER# ;2-. (ISSUED BY Dq
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SIGNAn-:u:
DA 1'E.
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SHIPPING ADDRESS:
......,
CONTACT PERSON:
PRONE: FAX:_
" I WOTJLD I..IIa: 'to PURCHASE TIm OmONAL ~'ELE INS1'.tUJ.
lXTE..~1J) W A.lUlAN'n'
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B. F AI1\MONT INSTALLATION:
FAIRMONr SIGl" COMPA...'VY IS TO COMPLETELY RANDLE Tl1E
INSTALI..A nON OF MY l'lPEL.INE PLUS StGNAG:L nns Xl(CLtl'D:ES AU..
EXTENDED W A.RRAN",rI.ES a W~ BE COMPLETE]) FOR TD FLUD
PRICE $VBMITTlD wrrBIN. TBJ', QUOTE ATTAC'BED. PERMIT COSTS,
ACQmsmoN &: ~~ SlECIALTY ITIl\'IS, SUCHAS STATJ: ENGINEERlNG
S'EAI..ED DRAWINGS A ZONING :BOARD OF Al'PEAL FEES. ARI .
ADDmONAL f1
SIGNA.TllllE~ X M ~':: ~ TITLE'~_
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u TJ! ~L CASI.S. !1.1CTR:!~~ aactT~ " CON1tt.cnONS AR:E TO B! CQ)'11PL!TED BY ~
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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:
3-1L/-cv
ReceivedO~~~V\ (_7), _Q.
the sum of _~ ~~
for the purpose of
dollars
Nata /lu:0 f-Juu A' __19 tntJ
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Invoice #
$
)01;"7-
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CROSSTOWN SIGNS, INC.
10166 HWY. 65 NE 612-784-7742
BLAINE, MN 55434
DATE 0-9-00
75-5743
919
7899 ';
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