HomeMy WebLinkAboutSign Permit 10-059 - SHEPHERD OF THE LAKECity of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. ST' 10 -59
uttcr.0 I TUNS: Clue completed application per sign is required. Applicant is I. PARCEL I.D. OF PROPERTY:
responsible for obtaining a building permit if necessary.
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Z. APPLICANT: (NAME) (ADDRESS) (PHONE)
L�CL�l I ZZ?-9 AUK; 5: _ ; (�vi P K wtnl `�SZ-5Z5 51
3. OWNER: (NAME) (ADDRESS) (PHONE)
,SKLPAab 6, - 1 I+j— C-Atc Lk -trk GAaLC I L Ki=Rwl I`r i''1ANc -�vti
4 SITE ADDRESS OR LOCATION OF SIGN (PHONE)
S�lI ^it1 = tZINt 1o4o (jt 1 gIt12 CA `i5Z Z_ -Z9 3
S. TYPE OF SIGN: TEMPORARY (21 DAYNfAX /MUMDISPLAI) PERMANEN (WA MARQUENAIVNINGIrREESTANDINGf
Bid /maze *Rusrness *Chungenb /e Copy Signs ConsrrrrctionSigns *E[eclronicMessnge l / /umia iens* Grslitu /ioaulSigns *Lnke Service Signs*
Multiple Residential Nameplate Signs *Orr- Prendse Directional Signs *Pernwnent Window Sign *Portable Sign *Subdivision Identification Signs
6. SIGN DIMENSIONS 10. Estimated Value of Sign
(square feet) (Height) (Width) (Depth) 7/5.&1''
�Z { � Z Zy t t 1 1 rr I / I1. Completion Date
7. TYPE OF CONSTRUCTION t � --
* tA jjt,�/
8. PROPOSED DISPLAY DATES (if applicable)
SIGN PERMITS 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 existing state and local laws and will proceed in accordance
with submitted plans. I am aware that the City Planner c pk permit far just cause. Furthermore, I hereby agree that City Officials or a designee thereof'
may enter upon the property to perform ceded ' ons.
�— <1
GN 'URE OF PROPERT REP DAT
Zfe ,' LII A
PRINTED NAME OF PROPERTY OWNER
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
�/t`ompleted Application
V Cale Drawing showing locationof sign
Plans and Specs
Permit Fee $ 3 (Permit fee is set
at time of application according to approved schedule)
This Application bee mes your 'g ► ermit when approved.
By
(( A Planner or esignee
Date
'his 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
equested. This document, when signed by the City Planner or designee constitutes compliance with the Sign Ordinance.
pecial Conditions
24 Hour Notice for All Inspections- 447 -9810
lhandoutslsign permit application 2010.doc
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