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City of Prior Lake
SIGN PERMIT APPLICATION
Permit No. ST
DIRECTIONS: One completed application is required PER SIGN.
1 1. PROPERTY IDENTIFICATION NO.
SIGN PERNHTS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE.
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2. SITE ADDRESS: t(770 p C 3. ZONING:
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4. APPLICANT: (NAME) (ADDRESS) (PHONE)
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5. OWNER: (NAME) (ADDRESS) (PHONE)
6. TYPE OF SIGN: (Please circle)
a. TEMPORARY: Balloon Sign Banner Sign Construction Sign Off- Premise Directional Sign Portable Sign =
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PROPOSED DISPLAY DATES! ,Ten
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b. PERMANENT: Awning Sign Lake Service Sign Marquee Sign Freestanding Sign Menu Board Sign
On Premise Directional Sign Permanent Window Sign Subdipi5ion Identification Sign Wall Sign
7. SIGN DIMENSIONS:
8. TOTAL WALL AREA:
(Total area) (Height) (Width) (Depth)
9. PERCENT OF WALL COVERED BY SIGNAGE:
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10. TYPE OF CONSTRUCTION/MATERIALS:
11. ESTIMATED VALUE OF SIGN:
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12. COMPLETION DATE:
A sign plan must accompany this application. Please attach a scaled elevation drawing of the total building front to
which the sign is to be affixed, accurately locating the sign.
If the sign is freestanding, attach a scaled site plan showing the exact setbacks of the sign.
The applicant is responsible for obtaining a building permit for freestanding signs over 6 feet in height.
I hereby certify that I have furnished information on this plicalion, which is, to the best of my knowledge, true and correct. I also certify that 1 am the owner
or authorized agent for the above - mentioned prop d the 'all construction will conform to all existing state and local laws and will in accordance
Officials designee
with submitted plans. 1 am aware that a an er c revoke this permit forjust cause. Furthermore, I hereby agree that City or a
thereof may enter upon the property ti p nee din dons,
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SIOV7AE OFIROP OWNERIAGENT DATE
This Application becomes your Sign Permit when approved.
FOR ADMINISTRATIVE USE ONLY:
Permit F li D- (Note: Permit fee is set at time of application according to approved schedule.)
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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 the Sign Ordinance.
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Special Conditions: L 7 U'"'�L 7Z - ' rD
' 24 Hour Notice for All Inspections
447.4230 from 9:00 a.m. - 10:00 a.m,
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