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APPROVED 1
City of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. I � % il
DIRECTIONS: One completed application per sign is required. Applicant is 1. PARCEL I.D. OF PROPERTY:
responsible for obtaining a building permit if necessary. 1
2. APPLICANT: (NAME) (ADDRESS) (PHONE)
-e: ,Gz.,. p - 'r ,y (4., k- Al
3. OWNER: (NAME) (ADDRESS) (PHONE)
ter
4. SITE ADDRESS OR LOCATION OF SIGN (PHONE)
5. TYPE OF SIGN: TEMPORARY (21 DA VMAXIMUMDISPLA 19 Wahalibk iALL/MARQUEE/ANNING /FREESTANDING)
Balloon Bmurer*Business*CI1angenble Copy Signs *Conslruction Signs *Illu mr • rgns *Institut oval Signs'LakeService Signs*
Multiple Residential Nameplate Signs *Ou Premise Directional Signs *Permanent Window Sign *Portable Sign *Subdivision Identification Signs
6. SIGN DIMENSIONS 10. Estimated Value of Sign
(square feet) (Height) (Width) (Depth)
S' La t CA, \ + .1--t („,21
11. Completion Date
7. TYPE OF CONSTR
F1 oy- t - , - l . x .1,N. r _ -,-, .. ,,
8. PROPOSED DISPLAY DATES (if applicable)
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE
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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. I am aware that the City Planner can revoke this permi for just cause. Furthermore, I hereby agree that City Officials or a designee thereof
may enter upon the property to perfo t ceded .. ections.
C ..A. -z t t t.....>) t i t
' . URE OF PROPERTY OWNERiA E T DATE '
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
t' Completed Application
Scale Drawing showing location of sign
Plans and �' ( Al � �/i
$
Permit Fee $ � + Permit fee is set { D r
at time of application according to approved schedule) i t t.l. l en ` P S vl
This Application b omes your Sign Permit when approved.
By ' '(1- -1 0 0 6 0
City Planner or designee
Date
fU1 13
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.
Special Conditions
24 Hour Notice for All Inspections
447 -4230 from 9 :00 a.m. - 10:00 a.m.
1:\handouts\2006 handouts \zoning\sign permit application.doc
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