HomeMy WebLinkAboutSign Permit 11-029 - Verizon WirelessCity of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. S ( — I 1 - 2— 9
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) 2J \20n U; i 2 I CSS (PHONE)
V AI.L- S'! (rrl /( i o vi-vT }} ifyL SE `)S -- q q - 7- LI-900
3. OWNER: (NAME) (ADDRESS) (PHONE)
G} - 4N,p WA-(-C--nJ 6o V80 By t, 0 Iy Ss+ A/E 611a - L f a '/ — 9d SS
4. SITE ADDRESS OR LOCATION OF SIGN (PHONE)
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K TYPEOFSIGN: TEMPORARY (21 DAY MAXIMUM DISPLAY) PERMANENT(NALUMARQUEEIA WNINGITREESTANDING)
Ba /loon'rBusiiiecs "Clmngeable Copy Signs *Constructlon Signs"Electronic Message •llbnnittatetiSigns•Lrstinrlional Signs•Lake Service Signs°
Multiple Reside,ttlal Nameplate Signs•Oit- Premise Directiouat Signs *Permanent IFiudow Sign °Portable. Sign *.Sitbdivtsion Identificntion.Signs
6. SIGN DIMENSIONS
lo. Estimated Value of Sign
(square feet) (Height) (Width) (Depth)
Il. Completion Date
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7. TYPE OF CONSTRUCTION
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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. 1 am aware that the City Planner can revoke p nit for just cause. Furthermore, I hereby agree that City Officials or a designee thereof
may enter upon the property to pertomt r E eH 6peell tu.
.
IR OF ROPE T OWNER/OWNERREP
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RIN�TF.D NAMF. OI:P POR ERTY
OWNER
FOR ADMINISTRATIVE USE
SUB W SSION REQUIREMENTS
J Completed Application
to Drawing showing location of sign
ans and Specs
Permit FCC$ L �(Pennitfeeisset
at time ofapplicatim according to approved schedule)
This Application comes your SIMPermit when approved.
By
City Planner or designee
Date 1 k
This is to ccrtity 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.
Special Conditions
24 Dour Notice for All Inspections- 447 -9810
IAhandoutsS.sign permit application 201 Rdoc
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