HomeMy WebLinkAboutSign Permit 10-043 - bannerCity of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. ~•~'~U `~ y~
DIRECTIONS: One completed application per sign is required. Applicant is 1. PARCEL LD. OF PROPERTY:
responsible for obtaining a building pern~it if necessary. 251770041
251770040
2. APPLICANT: (NAME) (ADDRESS) (PHONE)
4567 American Blvd W
Holiday Stationstores, Inc. Bloomington MN 55437-1123 952/830-8747
3. OWNER: (NAME) (ADDRESS) (PHONE)
4567 American Blvd W
Holiday Stationstores, Inc. Bloomington MN 55437-1123 952/830-8700
4. SITE ADDRESS OR LOCATION OF SIGN (PHONE)
Holiday Stationstore #198
16800 Duluth Ave SE
952/447-5051
_
5. TYPE Q.l~ IG ~TLiI~IPORA7/l f2/ DAI'AIAXIb!(IMDISI'LA}) PERbLANENT (li'ALUbIARQ(JEE/AiVNJNC/FREEST~INDLNG)
6nllootr~'(Bnuirer /3usiness ChangenGle Cop,7~ Sigus'Ca~slruclio~i Signs*Illrnninnted Sigtrs*lirstihr(ioi~nl Signs*Lnke Service Signs*
bLulliple Res~irtin nweplnte Signs*On-Preorise Directional Signs*Permm~eut -i'inr(arv Sign *Portnble Sign *Subr(iv/sion Ideal/frcntion Signs
6. SIGN DIMENSIONS ]0. Estimated Value of Sign
(square feet) (Height) (Width) (Depth) N A
32 4' 8' I1. Completion Date
N/A
7. TYPE OF CONSTRUCTION
N/A
8. PROPOSED DISPLAY DATES (if applicable)
August 6th & 7th
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOIVIPLETE
I hereby certify that I have furnished information on this application which is, to the best of my knowledge, true and con~ect. 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. 1 am aware that the City Planner can revoke this perntit forjust cause. Furthermore, 1 hereby agree that City Officials or a designee thereof
may enter upon the property to perform needed ins ections.
Holiday Stationstores, Inc.
SIGNATURE OP PROPERTY OWNER/OWNER REP DATE
James R. Hupp, Assistant Secretary
PRINTED NAME OF PROPER"fY OWNER
- --------------------
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
/~ Completed Application
~~ Scale Drawing showing location of sign
X Plans and Specs
Permit Fee $ % '> (Permit fee is set
at time of application according to approved schedule)
This Application becomes your Sign Pernpit when approved.
~,
~`'`
~
By
Plannero~designee
Date i / ` '
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 Ciry Planner or designee cons
titutes compliance with the Sign Ordinance.
/
Special Conditions ~ ,~ ..,~~ i~1~1 ~'( '° ~~~ t,.1~~~t .~ •,-.L- :~ 7•r; ?; ~ 14-~ X4'1 /~' i : '_~- /,7~~'(~' ~~'~ ~~ }'~~ ~~~
24 Hour Notice for All Inspections- 447-9810
c:\documents and settings\mtpeterson\local settings\temporary intemet files\content.outlook\kekwfnhd\sign permit application.doc
EXAMPLE
.1K * ~' 2422 Enterprise Drive
Mendota Heights. MN 55120
* PIONEEF! LAND SURVEYORS • CIVIL ENGINEERS (612) 681-1914 FAX:681-9488
eng neer~ng LAND PLANNERS • LANDSCAPE ARCHITECTS 625 Highway 10 N.E.
Blaine, MN 55434
~[ * ~ (612) 783-1880 FAX; 783-1883
Certificate of survey for: HOLIDAY COMPANIES, INC.
Location: HOLIDAY STATIONSTORE. PRIOR LAKE. MN
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LOT LEGAL DESCRIPTION PROPOSED BUILDING ELEVATION: ~ .,n (at door)
Bearings shown are assumed
LOT 1 ~ ~' LOCH 2 • 900.o Denotes Existing Devotion
~ Denotes Proposed Eevotion
Denotes Drainage Flow Direction
-~- Denotes Monument
BRooKS I//L L E G ENTER -~ Denotes offset krr~ 12oFl
NOTE: Propoeed bulldinq elte elevatlone are In accordance with
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2 Np /-~DAI T~[OtV the development plan oppro~ed by the city engineer.
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MinrTPSo{a NOTE: Contractor moat verify all dlmmelone & driveway/parking lot dealgn.
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We hereby certify that this survey, plan or report wos prepared by me or under my
direct euper+Aelon and that I o duly Ilcenae Lond Surveyar~under the Iowa of the
the Stote of Nlnneaota. Dated this ~ day of ~ ~ A,D. t9,!Y~
Signed: P EER ENGI ING
Scale: /~
1~=50reet By.
Robert B. SI Ich, L.S. Reg. No. 14891 or
15089506 Terrence E. Rothenbacher, L.S. Reg. No. 20595