HomeMy WebLinkAboutSign Permit 10-24 Prior Lake Rotary ClubCity of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. 5~-~U Z y
DIRECTIONS: One completed application per sign is required. Applicant is t. PARCEL [.D. OF PROPER'rl':
responsible for obtaining a building permit if necessary.
~5. c>Ul. a2
2. APPLICANT: (NAME) (ADDRESS) (PHONE)
~~'~ov l.A~e ~o'~v~vl C~lvb
3. ~ (
NAM
E
)
(ADDRESS)
(PHONE)
'(~~.,
T
/
,/
~
/G~V~ C7G~ L°~~ 1p ~Z ~iJ ~ \{
4. S[TE ADDRESS OR LOCATIO F SI N ({'HONE)
5. TYPE OF SIGN: TEMPOxARr(z1 DA MAXI Uhl D/SPLAY) PER ANENT (WALUhfARQUEE/AWNING/FREESTANDLVG)
Rul/oon * Banner*Business*Changeable Copy Signs*Cautniction Signs */llurnirwted Signs*/ns7itulionu! Sigru *Loke Service Signs
Multiple Residential Nameplate Signs*On-Premise Directional Signs*Pennaren( Window Sign*Portuble Sign *Subdivision Identification Signs'
6. SIGN DIMENSIONS 10. Estimated Value of Sign
$
(square feet) (Height) (Width) (Depth) ~0~ ~ DO
~f ( p 1 ~1
o 11. Completion Date
7. TYPE OF CONSTRUCTION
I"1 ~ y t/V~ l V~ \f ~/V~
8. PROPOSED DISPLAY DATES (if applicable) I
5 /O~
~/
- ~
/~J
~
tU
--
SIGN PERMITS WILL NOT BE PROCESSED [F 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 existing state and local laws and will proceed in accordance
with submitted plans. I am aware that the ~ tanner can revoke this permit for just cause. Furthermo[e, I hereby agree that City Ofticials or a designee thereol
may enter upon the property [o per needed ink ec '
ii
SIGN "f E OF P '(>ERTY OWNER/AGENT
DA"1 E
-- -------- --------------
FOR ADMINISTRATIVE USE
S
UBMISSION REQUIREMENTS
j
/~ Completed Application
Scale Drawing showing location of sign
Plans and Specs
~ Permit Fee $ l S° ~*~ (Per-mit fee is set
at time of application according to approved schedule)
This Application becomes your Sign Permit when approved.
Y
City Planner or designee
Date ~~/l~ ~/CJ
This is to certify [hat 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 Ci
ty Planner or des
ignee constitutes compliance with the Sign Ordinance
.
//
1
s
Special Conditions GGirirlo ~ DOS~i~UC % /~D~it ~/-q ~j ~ /~~P$°¢~~ ~ ~ `
!~/arm s /~-n ~i ~b~S~ t~ti,~/a/ ~~- ~ ~ /~ 1%~l, ~ ~3O o~~ ~~s --
24 H r Notice for All Inspections
447-4230 from 9:00 aun. - 10:00 a.m.
c^~documents and settings\jma[zke\local settings\temporary in[emet tiles\olkl 13\sign permit application.doc
Scott County, MN
r ~ ~ +
~..~ t r ~. r e ~ , , ~, -~+..-- ~ ~r:55
___ .:
~_ ~ - _,~
This drawing Is neither a legally recorded map nor a survey and is not Map Scale
intended to be used as one. This drawing is a compilation of records,
h = 60 feet
1 i
information, and data located in various city, county, and state offices, and nc
other sources affecting the area shown, and is to be used for reference
purposes only. Scott County is not responsible for any inaccuracies herein Ma Date
contained. If discrepancies are found, please contact the Scott County p
Surveyors Office. 5~1 0201 0
N