HomeMy WebLinkAboutSign Permit 00-026
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City of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. (!;{? ....{)~
DIRECTIONS: One completed application per sign is required. Applicant is
responsible for obtaining a building permit if necessary.
2. APPLICANT: (NAME)
(ADDRESS)
PO. S3Cf
(ADDRESS)
1. PARCEL I.D. OF PROPERTY:
zr-i~-ro[J-O
(PHONE) ~j ~ 11.t.
\ ~b Ll9
3. OWNER: (NAME)
%nn !d f.~4nr
4. SITE ADDRESS OR LOCATION OF SIGN
<'\> ("' \ 0(" La ILl
4L/O-2.Cf33
(PHONE)
15 7.-
5. TYPE OF SIGN: TEMPORARY (21 DAYMAXIMUM DISPLAY) 'RMANE 'ALLlMARQUEE/AWNING/FREESTANDING)
Balloon * Banner* Business *Chllngeable Copy Signs*Conatruction Signs * muminllle igns * Institutionlll Signs * Lake Service Signs*
Multiple ResidentUzl Nllmeplllte Signs*On-Premue Directionlll Signs*Permllnent Window Sign*Portllble Sign*Subdivuion Identificlltion Signs
(PHONE)
447-
6. SIGN DIMENSIONS
(square feet)
I
(Height)
J 2. "
7. TYPE OF CONSTRUCTION
rp lc&s..-\-.\ ( l.l if-~ r ~
8. PROPOSED DISPLAY DATES (if applicable)
(Width)
r
(Depth)
10. Estimated Value 1;~n
11. Completion D
((
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE
/
I hereby certify that I have furnished information 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 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 neede? ins ections.
1St) 1/'1
/D-/3-DO
DATE
FOR ADMlNISTRA TIVE USE
SUBMISSION REQUIREMENTS
~mpleted Application
Scale Drawing showing location of sign
::::i2:'Plans and spec~
_ Permit Fee $ iIQ (permit fee is set
at time of application according to approved schedule)
Tb.. APPn.a:. bec~mes ~b'. approved.
~~--~
Date /;19/13/60
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.
~ f9F-
l:\handouts\signform.doc
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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 #
38513
! (-;5-oD
DATE:
Received of ~
the sum of
for the purpose of
7Jc;
fW /td)
I
~
dollars
P- :&~~
#f'V-O~
$ 0tliD
Invoice #
PRIOR LAkE ..~X"AGE AB~SCHOOLS
. INDEPENDENT SCHOOLDISTBICTNO,]19
ACCOUNTS PAYABLEJ612-447-2185 .
pRIOB LAKE. li,1INT'fESOT A 55372Sb539
:E2 8j[~ 6
CHECKNO.
CENTS
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. 10/31./00.
PAY TO THEORDER OF:
CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE MN 55372
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