HomeMy WebLinkAboutSign Permit 01-019OF PRI' ' V
A. City of Prior LakePKasoo
a� X APPLICATION FOR SIGN PERMIT
°j�roroeaot* Permit No.
DIRECTIONS: One completed application per sign is required. Applicant is 1. PARCEL I.D. OF PROPERTY:
responsible for obtaining a building permit if necessary. bCYL
2. APPLICANT: (NAME) (ADDRESS) 1"�' L c,t, (PHONE)
�usa� (9 lQ s 6L P1 � io X21 � aL� � � ' 9�2 � z z � -1 � 77
3. OWNER: AME (ADDRESS) (PHONE)
aC�����
4. SITE ADDRESS OR LOCATION OF SIIGN (PHONE)
Jri c rd -1-oc 4�0 i J� C"✓l c R "� (� - l fo 77
5. TYPE OF SIGN: TE ORARY(21 DAYMAXWVMDISPLAiD PERMANENT(WALLMARQUEF✓AWNINGIFREESTANDLYO
Balloon* Banner*Business*Changeable Copy Signs*Construcdon Signs*Illuminated Signs*lnsda denal Signs*Lake Service Signs*
Muldple Residential Nameplate Signs*On Premise Directional Signs*Permanent Window Sign*Portable Sign*Subdivision Idend,Jicadon Signs
6. SIGN DEWENSIONS 10. Estimated Value of Sign 4y2 �� )Pwli
(square feet) (Height) (Width)' - (Depth) 11.
2 7C'� tib
] 11. Completion Date
7. TYPE OF CONS UCTION
g. PROPOSED DISPLAY DATES (if applicable) ,• o r(o v S OoLyS- �
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE
I hereby certify that I have famished 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 revo a this permit for just cause. Furthermore, I hereby agree that City Officials or a designee
thereof may enter upon the property to need inspec ' .
SI NATURE OF 1T OPERTY OWNER/AGENT DATE
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
1/ Completed Application
LLScale Drawing showing location of sign [�
erand Spec
nit Fee $ `�® (Permit fee is set 6
at time of application according to approved schedule)
This Application becomes yo Sign Permit when approved.
By
itygqP ann %coram ygnee
Date 6 4 U" �-"G
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 documentb when signed by the City Planner or designee constitutes compliance with the Sign Ordinance. a
1-4 .e
Special Conditions
!' 24 Hour Notre for All lnspecnQils
4474230 from 9:00 a.m. -10:00 a.m.
1:Viandouts\signfomi.doc
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