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APPLICA'T'ION FOR SIGN PERMIT
Permit No. 0
DIRECTIONS: One completed application per sign is required. Applicant is
1. PARCEL I.D. OF PROPERTY:
responsible for obtaining a building permit if necessary.
25. 2:F5. 0 0 2 •�
2. APPLICANT: (NAME) (ADDRESS) (PHONE)
LAy-o- Ro a�v� a00
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3. (NAME) (ADDRESS) (PHONE)
eve3e��
4. SITE ADDRESS OR LOCAATIOO F SIGN ryll!].. �)
—pr N ( �/ I,( 'N -7—UP
U✓ LAk J X e Ilk^ J — - bV ` 1 \- / 4ye I
S. TYPEOFSIGN: TEMPORARY(21 DA YMAXIMUM DISPLAY) PERMANF. NT( WALI /MARQUEE/AfVNING17RFL'SIANDING)
Balloon * Banner-Business-Changeable Copy Sigus•Constractiun Signs *fllumimted Signs *Institutional Signs *Lake Service Signs'
Muldple Residential Nameplate Signs *On - Premise Directional Signs *Pennunew Window Sign Sign *Subdivision Identification Signs
6. SIGN DIMENSIONS
10. Estimated Value of Sign
(square feet) (Height) (Width) (Depth)
S-00, QD
I1. Completion Date
-- 7- , / I e 1 �1
o
7. TYPE OF CONSTRUCTION
Alvah v,,.
S. 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
or authorized agent for the above -m boned property, and that all construction will conform m all existing state and local laws and will proceed in accordance
with submitted plans. I am aware Thal t City F . er can revoke this Penn" in" as cause. Furthermore, I hereby agree that City Officials or a designee thereof
may enter upon the property to perform nee d lust c ta.
S1'NA RE OFP O ERTY OWNL•R/AGLN'I' DATE
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
X Completed Application
Scale Drawing showing location of sign
Plans and Specs
pemut Fee S _�, (Permit fee is set
at time a] application according to approved scheJule)
This Application becomes your Sign Permit when approved.
ay
City Planner or designee
Date
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 City Planner or designee constitutes compliance with tile Sign Ordinance.
Special Conditions
24 Hour Notice for All Inspections
447 -4230 from 9:00 a.m. - 10:00 a.m.
aldocumems and scttings\jmutzke \local sellingsVemporary internet filvOolkl 131sign permit application.doc
Scott County, MN
This drawing is neither a legally recorded map nora survey and is not
intended to be used as one. This drawing is a awn oilation of recards,
information, and data located in various uty, wunty, and state .11i and
other sources affecting the area shown, and is to be used far reference
purposes only. Stull County is not responsible for any inaccuraues herein
wnlained. If discrepancies are found, please wnlact the Swtt County
Surveyors Office.
Map Scale N
1 inch = 80 feet
Map Date Scot 1217/2009 S +