HomeMy WebLinkAboutSign Permit 01-007
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City of Prior Lake ~
APPLICATION FOR SIGN PERMIT (f/
PermitNo. {{)( ...f907
DIRECTIONS: One completed application per sign is required. Applicant is
responsible for obtaining a building permit ifnecessary.
1. PARCEL Ln. OF PROPERTY:
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2. APPLICANT: (NAME. ) (AD. DRffi l \ (PHONE)
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3. OWNER: (N ) . , (ADDRESS) (PHONE)
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4. SITE ADDRESS OR LO<::ATI N OF SIG} _,.... _ I ~ f\ '" (PHONE)
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5. TYPE OF SIGN: TEMPORARY (21 Y MAXIMUM DISPLAY) PERMANENT (WALLiMARQUEElAWNING/FREESTANDING)
Balloon * Banner*Business*ChangealJle Copy Signs*Construction Signs*IUumlnated Signs*InstltutJonal Signs*Lake Service Signs*
Mu/Jiple Residential Nameplate Signs*On-Premlse DlrectiolUll Signs*Pel'11llUlBnt Window Sign*Portable Sign*Subdlvlslon Identification Signs
6. SIGN DIMENSIONS
(square feet) (Height)
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7. TYPE OF CONSTRUCTION
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10. Estimated Value of Sign
(Depth)
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11. Completion Date, t
I hereby certify that I have furnished infonnation on this application which is, to the best ofmy lmowledge, true and correct. I also certify that I am the owner
or authorized agent for the above-mentioned perty, and that all construction will conform to all existing state and local laws and will proceed in accordance
with submitted plans. I am a that the Planner can revoke this permit for just cause. Furthermore, I hereby agree that City Officials or a designee
thereof may enter upon the property orm ne jnspections: ---l _,
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DA'TE
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
~ompleted Application
V'Scale Drawing showing location of sign
_ Plans and Spec~ ,....... Ae
~ermit Fee $ . 5 ~ (permit fee is set
at time ofapplication according to approved schedule)
B
Date
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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.
Special Conditions
24 Hour Notice for All Inspections
447-4230 from 9:00 a.m. - 10:00 a.m.
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l:\handouts\signform.doc
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