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APPLICATION FOR SIGN PE
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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.
2. APPLICANT: (NAME) (ADDRESS) (PHONE)
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3. OWNER: (NAME) (ADDRESS) (PHONE)
4. SITE ADDRESS OR LOCATION OF SIGN (PHONE)
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5. TYPE OF SIGN: T'EMPORARY(21 DAYMAXLKUMDISPLAI~ PERMANENT (R'ALL/MARQUEE/AWNIIVG/FREESTANDING~
Balloon* Banner*Buslness*Changeable Copy Signs*Constraction Signs*I/laminated Slgmc*Inst/trrrlonal Signs*Lake Service Signs*
Multiple Residential Nameplate Signs*On Premise Diretxi'onal Signs*Permanent Window Sign*Portable Sign*Subdivision IdentiJlcadon Signs
6. SIGN DIlVIENSIONS lo. Estimatoe~ Valve of Sign
uare feet) (Height) (Width) (Depth)
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3/ 11. Completlfon Date
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7. TYPE OF CONSTRUCTION
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8. PROPOSED DISPLAY DATES (if applicable) ~l ~ ~- _ o ~ ~.1j l Z - 2, Z -~, ~
SIGN PERNIIT5 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 erdsting state and local laws and will proceed in accordance
with submitted plans. I am aware that the City Plarmer 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 nee ections.
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SIGNA PERTY OWNER/AGENT D TE
FOR ADMIMSTRATIVE USB
SUBMISSION REQUIREMENTS
r/ Completed Application
~'LScale Drawing showing location of sign
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Permit Fee $ r~ (Permit fee is set ~ ~°~ V~~~j~ `
at time of application according to approved schedule) ~~ L- A ` i,,
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This Application beC nes your Sign Permit when approved. /~~~A~
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By
City Planner r designee
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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 documen when signed by the City Planner or designee constitutes compliance with the Sign Ordinance.
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Special Conditions ._._. C if ~
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24 Hour Notice for All Inspections
• 447-4230 from 9:00 a.m - 10:00 a.m.
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RECEIPT
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CITY OF
PRIOR LAKE
16200 Eagle Creek Avenge S.E.
Prior Lake, MN 55372
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DEPARTMENT: ~
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PRIOR LAKE
16200 Eagle Creek Avenue S.E.
Prior Lake, MN 55372
DEPARTMENT: ~~
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The sum of
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