HomeMy WebLinkAboutSign Permit 13-33 City of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. I r 33
DIRECTIONS: One completed application per sign is required. Applicant is I. PARCEL I.D. OF PROPERTY:
responsible for obtaining a building permit if necessary.
2. APPLICANT: (NAME) (ADDRESS) (PHONE)
Sian ( PorAgt'\l 2.00 , xict Vd,, L ki Ito/1 (4)-(a-0503
l S -05'3
3. OWNER: (NAME) (ADDRESS) it, S (PHONE)
4. SITE ADDRESS OR LOCATION OF SIGN (PHONE)
/6)(163 20)04 -)'
5. TYPE OF SIGN: TEMPORARY (3t7 DAY MAXIMUM DISPLA17 PERMANENT ( WALL /MARQUEEIAIVNING/FREESTANDING)
Balloon *BnsJ Hess *Changeable Copy Signs *Construction Signs *Electronic Message *Illnnninated Signs *Institutional Signs *Lake Service Signs*
Multiple Residential Nameplate Signs *Orr - Premise Directional Signs *Permanent Window Sign *Portable Sign *Subdivision Identification Signs
4. SIGN DIMENSIONS to. Estimated Value of Sign
(square feet) (Height) (Width) (Depth)
C P/ 1%15 „., Ir tr 11. Completion Date
7. TYPE OF CONSTRUCTION
8. PROPOSED DISPLAY DATES (if applicable)
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE
1 hereby certify tint I have furnished infonnation on this application 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- rnentioned property, and that all eonstmction will conform to all existing slue and local laws and will proceed in accordance
with submitted plans. I am aware that the City Planner can revoke tki permit for just cause. Furthermore,1 hereby agree that City Officials or a designee
thereof may enter upon the property to perfonnnceded in • 10 . ,rrr r
SIGNATURE OF PROPE T '' WNER/OWNER REP DATE
•"
ds. Cr
PRINTED NAME OF PROPERTY OWNER
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
5ompleted Application
V ale Drawing showing location of sign
Plans and Specs cr
Permit Fee $ '1 9.� 1 (Permit fee is set
at time of a placation according to approved schedule)
This Application 1 • o ,, . your Sign Permit when approved.
By I 0 a i
— Ci Planner r desinee
Date 1, 1 ( ( �°
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 desigree constitutes compliance with the Sign Ordinance.
Special Conditions
24 Hour Notice for All Inspections- 447-9810
Iahandoutslsign pcnnit application.doc
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