HomeMy WebLinkAboutSign Permit 00-012
~
City of Prior Lake
APPLICATION FOR SIGN PERMIT
(!}J:> - OJ J,
PermitN~
DIRECTIONS: One completed application per sign is required. Applicant is
responsible for ob a building permit ifnecessary.
i ",1) 5
2. APPLICANT: (NAME)
t. Jt1.e.-J" CAVA..-
(NAME)
I (/JIo() TnI{6IVIO j)()~ S ~ .
4. SITE ADDRESS OR LOCATION OF SIGN
1. PARCEL I.D. OF PROPERTY:
TOlZ.-opuTo A-P~ 5t:
(ADDRESS)
,{a.-r/ ~
3. OWNE :
/l}-eh..~UJk5 f4tJ-<; S[.
t!Z,;Z6 ~S.3 s ~
(PHONE)
.Jjf'? -;2)4>'8
(PHONE)
R::lh-S3S-t,
(PHONE)
13 tUV)O oQ..J'L
5. TYPE OF SIGN: TEMPORARY (21 DAY MAXIMUM DISPLAY) PERMANENT(WALL/MARQUEE/AWNING/FREESTANDING)
Balloon * Banner*Business*Changellblt! Copy Signs*Construction Signs*IUuminllted Signs*Institutiontd Signs*Lake Service Signs*
Multiple Residentilll Namephzte Signs*On-Premise Directional Signs*Permanent Window Sign*Portablt! Sign*Subdivision Identification Signs
6. SIGN DIMENSIONS
(square feet) (Height)
;z. if
7. TYPE OF CONSTRUCTION
{~j{J d Tl e:/J ;Jc
8.. PROPOSED DISPLAY DATES (if applicable) _ /" /~~
.5L//dtJ - ~~_dO
SIGN PERMITS Wll..L NOT BE PROCESSED IF Y INCOMPLETE
10. Estimated Value of Sign
(Width)
9
(Depth)
11. Completion Date
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 needed inspections.
S~/~O.
'DA
FOR ADMINISTRATIVE USE
~SSION REQUIREMENTS
~ompleted Application
-trL ~~ale Drawing showing location of sign
k.A:s and spe1 6' I 1\ -
ermitFee$ :0'~ (permit fee is set + L-~~ I~~
a me of application according to approved schedule)
This Application becomes your ign Permit when approved.
By
Date
Special Conditions
ro~v.)
~
~
24 Hour Notice for All Inspections
447-4230 from 9:00 a.m.. 10:00 a.m.
I:\handouts\signform.doc
(
RECEIPT
DATE~
CITY OF
PRIOR LAKE
16200 Eagle Creek Avenue S.E.
Prior Lake, MN 55372
Received of
dollars
The sum of
For the purpose of %t '
~, fJ ~~
($ilK ---
$ l5,00
:Y
\"-----------
\
(~
\
\
\,
\
~(J
'(7
\
\
~,
'----
""""'--
."'............ ,.....
~,
'~'7'
\./
\f\
4
~~
~
C7
(;
/'
~
~
'-."
~
()
'-."-
\:::
~...t
r
(I;
~--
~
~
()
r --f, "'~~l
f'~ c
..
r "
-t ~
~
c ~
t
/
0 r
"-""""'"