HomeMy WebLinkAboutSign Permit 11-014 - panel changeCity of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. J 1— ` I l I
DIRECTIONS: One completed application per sign is required. Applicant is
1. PARCEL I.D. OF PROPERTY:
responsible for obtaining a building permit if necessary.
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2. APPLICANT: (NAME) (ADDRESS) 0 �� I / H I 17� o (PHONE)
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3. OWNER: (NAME) (ADDRESS) (PHONE)
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4. SITE ADDRESS OR LOCATION OF SIGN (PHONE)
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5. TYPE OF SIGN: i 1'B rPORARY(2i DAYMAXIMOMDISPLAyl MW FSTANDIN
Balloon *Business*Changeable Copy Signs*Com1ruction Signs *Elechonic Me stage* MmunaredSigns -Imul(/onalSigns-Lake Ser iceSignr-
MallipleResidenrtal NameptmeSign s *On- Premise Directional Signs *Permanent WindowSlgn *Porrohte Sign *Subdivision Identification Signs
6. SIGN DIMENSIONS — sokine s;Ze coca lci1 Nis V
Ill. Estimated Value of Sign
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(square feet) (height) (Width) (Depth)SiJn
11. Completion Date
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7. TYPE OF CONSTRUCTION
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8. PROPOSED DISPLAY DA (if applicable) } ,� A I S
SIGN PERMITS WILL NOT BE PROCESSED If THEY ARE INCOMPLETE
1 hereby certify that I have famished information on this application which is, to the best of my knowled , true and correct. I also certify that] am the owner
or authorized agent for the above-mentioned property, and that all construction will conform m all exi'sli g state and local laws and will proceed in accordance
with submitted plans. Ism aware that the n mvok tldspermit just cause. Funhe �re,Ihereby agree that City Officials oradesigncc thereof
may enter upon the property To perfa eed tiuns. ,, 5" / ✓/
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FPROPER OW OWNER REP DATE
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PRINTED NAME OF PROPERTY OWNER
FOR ADMINISTRATIVE USE
REQUIREMENTS
/ SUBMISSION
Completed Application
Scale Drawing showing location of sign
_ Plans and Sp�e�nsI n
Permit Fee (_ (YCrmit fee is set
at time of application according to approved schedule)
This Application ecumesyourS�RnPermitwhenapproved.
By � 2
Plam or or designee
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Date U I ~0 7 -11
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 n h 1 lift [II `' p ) �f
24 Moor Notice for All Inspections -447 -9810
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I:Viandouts \sign permit application 2010.doc
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