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Sign Permit 14-10 Allstate
City of Prior Lake j �P S late_ eta c APPLICATION FOR SIGN PERMIT X. / t c9 V' lI S C ---C3 iii- -- Permit No. DIRECTIONS: One completed application per sign is required. Applicant is 1. PARCEL I.D.. OF PROPERTY: responsible for gbtaining a building permit if necessary. 5 /C'; /) (C Q ( 1>V� �l� c.1. 4 J �' 2. APPLICANT: (NAME) f (ADDRESS) (e j (PHONE) ✓ �f �j s ()»/1 - i2 4 /C , 0 A Y975 /i Me I af» 53 6(7- ; 6 ' 7U 3. OWNER: (NAME) (ADDRESS) r (PHONE) .94$JJ UL- o &ri e S S )( 3C 5 t r l0,- 03iZ- / '7 ge) 0 qZ 7 4. SITE ADDRESS OR LOCATION OF SIGN (PHONE) ( � V 3 7j Co(1(4yt , lc ( j 14 A.1 _.- 5" 7Z peu�i 5. TYPE OF SIGN: TEMPORARY (3© DAY MAXIMUM DISPLAI) .' PERMANEN' (WALL✓MARQUEFJAWNING /FREESTANDING) Balloon `'Business *Changeable Copy Signs °Construction Signs *Electronic Message *llluminated Signs *Institutional Signs *Lake Service Signs* Multiple Residential Nameplate Signs *On- Premise Directional Signs Permanent Window Sign *Portable Sign Subdivision Identification Signs *Note if the sign structure is above 6 feet the international code warrants a building permit. 6. SIGN DIMENSIONS 10. Estimated Value of Sign f ?q5 00 (square feet) (Height) (Width) (Depth) ( i «�' S per` f h t rr (P t � tl �' J , l 11. Completion Date ,X 3 / // / 7 : f zc 7. TYPE OF CONSTRUCTION 914 kLii Leiler ) GAiNu 6 GI S�Uuc t --- 8. PROPOSED DISPLAY DATES (if applicable) SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE 1 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 Iaws and will proceed in accordance with submitted plans. I am aware that the City Planner can revoke this permit for just cause. Furthermore, I hereby agree that City Officials or a designee thereof may enter upon the property to perform needed inspect' ns. / Z- /I SIGNATURE OF PROPERTY OWNERJOWNER REP DATE R0 14 r 66. t s5 PRINTED NAME OF PROPERTY OWNER FOR ADMINISTRATIVE USE SUBMISSION REQUIREMENTS �� ��� Completed Application �j J` 4 C 10-N5 ,0/ ,Scale Drawing Sp � p tX (Permit fee is set /� showing * location of sign .__ "Peermrm and P it Fee $ Stir' C, K /' iJ lG/YW at time of application according to approved schedule) (1 This Application 13 . i mes your Sign ' • rink when approved. q �J 1 City Planner or design:: APPROVED 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. Special Conditions L•\handouts\sign permit application.doc fa PH; ADL-LPI HASIGN r:il-., kph; e Si , t trip. ny • 7O i West Spniit Gude,' Si - ?linty! a. NI C::'■' .-- /1) .11.VPKI !A .., , . S,; cep 2 / P_0.1 ( ' AI '5.? 7 AUTHORIZATION AND CONSENT FORM 13" nay signature below. I hereby represent that I am the owner of thc properly indicated above or otherwise duly authoriled by the Lease to grant authorization fur Philadelphia Sign Company and/or their sub contractor to apply for permits and install new signnge ut the above referenced location. — — 0 ,,..4 j A.,/- L,41`T?_1 APPROVAL t ' Ci.- 1- A3 C - 1 -- ?- p-,..--c_c--.•-• t ) PL Sj , 1 0 ‘'...:e 1.' Aame (.1 ;FAX7CLICI ' tii owe . 7,//-2 0/eN, 1ek ,-, _ move .._ O 0 9 2 — ) — _ _ — ii, f ,.,: , 'xi. Philadelphia Sign Company 707 West Spring Garden St Palmyra, NJ 08065 ra 1 AX1 (856) 829-8549 attn: Erie Assertheinter _ _. .. .. 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