HomeMy WebLinkAboutSign Permit 00-028 wall
City of Prior Lake
APPLICATION FOR SIGN PERMIT
ID..~?
Permit No. !:V-b~
1. PARCEL Ln. OF PROPERTY:
5-902.-0<+,-
(PHONE)~;~ 11.tl
LfL1D -2tj33
(PHONE)
Ylf7-5S37
(PHONE)
AvlV\~Trr~ Q. 440-2.933
5. TYPE OF SIGN: TEMPORARY (21 DAY MAXIMUM DISPLAY) QERMANEJ!jxwALL/MARQUEE/AWN1NGlFREESTANDINGJ
Balloon* Banner*Business*Changeabk Copy Signs*Constl'llcdon Signs*1lluminated Signs*Institutional Signs*I.IzU Servictl Slgll8*
Multiple Residential Nameplate Signs*On-Premise Directional Signs*Permanent W"mdow Sign*Portabk Slgn*Subdivision IdentijictltUJn Slgll8
DIRECTIONS: One completed application per sign is required. Applicant is
responsible for obtaining a building permit if necessary.
2. APPUCANT: (NAME) (ADDRESS)
is\) I)Cf vD ~X 53q
(NAME) (ADDRESS)
::r-OhY\ 5~e U O_fr
4. SITE ADDRESS OR LOCATION OF SIGN
3. OWNER:
Ilo5U
6. SIGN DIMENSIONS
(sqUare feet)
(Width)
fl'
(Depth)
(Height)
) 21
7. TYPE OF CONSTRUCTION
~S+-i'C-
8. PROPOSED DISPLAY DATES (if applicable)
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 confonn 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. IS D 7/ t:(
~;~ ./(~/~
IGNA TURE OF PROPERTY OWNER/AGENT
/D-/3-('X"'J
DATE
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
~mpleted Application
V Scale Drawing showing Ideation of sign
""""\7mans and Specs \
zPermit Fee $ (~ (PCt:mit fee ~ set
at time of application according to approved schedule)
This Application becomes your Sign Permit when approved.
By
Date
City Planner or designee
[0/1.:/ ~
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.
...
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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
I ( -;!;; -cJD
DATE:
Received of ~
the sum of
for the purpose of
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dollars
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Invoice #
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.. . PRIOR. LAKE ~SAVAGE ABE.ASCAaOLS
..JNOEPENDENT SCHOOLDISTHICTNO,]1!;J
ACCOUNTS PAYABLEl612-447-,2185 ......
.....PRfORLAKE.MINNESOTA 55372~539.'
:112 8I.~ 6
CHECKNO.
\PAY TO THE ORDER OF:
CENTS
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CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE MN 55372
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