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City of Prior Lake
APPLICATION FOR SIGN PERNIIT
Permit No.."~-~-I
DIRECTIONS: One completed application per sign is required. Applicant is 1. PARCEL I.D. OF PROPERTY:
responsible for obtaining a building permit if necessary. oZ5" ~-) -~ -~~~
Z. APPLICANT: (NAME) (ADDRESS) (PHONE)
iT~~,l ~.> ~,7~- C~®~7 f r~ E~/~P .5~~e~ ~hr>. S.S~~~ off°,~.,~° 7~®
3. OWNER: (NAME) (ADDRESS) (PHONE)
4. SITE DRESS OR LOCATION OF SIGN (PHONE)
5. TYPE OF SIGN: TEMPORARY(21 DAYMAXI161UMDLSPLAI~ PERMANENT (WALLMARQUEF./AN'NING/F'REESTANDING7
BaUoon* Banner*Business*Changeable Copy Signs*Construction Signs*IfQunrinated Signs*Institudonol Signs*loke Service Signs*
Multiple Residential Nameplate Signs*On Premise Directional Signs*Pernrane~ Window Sign*Portable Sign*Subdlvisfon IdentiJlcadon Signs
6. SIGN DIMENSIONS 10. lr"stlmated Valve of Slgn ~ S~ . _
th)
ht) (Width) (De
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(square feet) ( ~
Completlon Date
11.
STRUCTION
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PE OF CO
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8. PROPOSED DISPLAY DATES (if applicable)
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
-
p proceed in accordance
or authorized agent for the above-mentioned property, and that all construction will conform to all existiag state and local laws and ~
with submitted plans. I am aware that the City Phumer can revoke this permit for just cause. Furthermore, I hereby agree that City Officials or a designee
thereof may enter upon the property to perfo wee et~ 'ons.
SIG ATURE OF PROPERTY O AGENT DATE
FOR ADMIMSTRATIVE USE
SUBNIISSION REQUIlLEMENTS
Completed Application
Scale Drawing showing location of sign
Plans and Specs
~_ Permit Fee $ 33•? S (Permit fee is set
at time of application according to approved schedule)
This Application becomes your Sign Permit when approved.
,,~1 , -~t~-~1M~. M~la,.~._
City Plamter or designee
Date ~~ OY
This is to certify that the request in the above application and accompanying documents is in accordance with the City Sign Ordinance and rt~y proceed as
the City Planner or designee constitutes compliance with the Sign Ordinance.
requested. This document, when signed by
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Special Conditions ~ a i.7!- RX : O'r ~ ~ Q~~bV~ ~t,lDl •
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4 Hour Notice for All Inspections
447-4230 from 9:00 a.m. -10:00 a.m.
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11!15/2004 07:57 6058823521 PERSONA INC PAGE 10110
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T1TLE DRMtG. N0. SHEET OF
~~~~ PYLON ELEVATION H74-99/114 1 4
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Wahrte~xSD 97~p (BO5j~6ezhw22 AS NOTEQ UAJA .G/26/99 DRS
CUSTOMER LOCATfON REYF310N5 DAT£ 8Y
HQUDAY (UR. (~,, Ml~( ~ jig
aAT~ OF APP(taYu
p~ PRIO
.p CITY OF PRIOR LAKE
J+ 16200 EAGLE CREEK AVE SE
Er
,,,~ ~ PRIOR LAKE, MN 55372
V ~ (952) 447-4230, FAX (952) 447-4245
~~NNESO~P
RECEIPT# 48.42
DATE: ~ `~~~C ~
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the sum of 1 VI
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_ dollars
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Invoice #
Receipt Clerk fo t e City of Prior Lake