HomeMy WebLinkAboutSign Permit 03-004 Eagle Creek Chiro
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City of Prior Lake
APPLICATION FOR SIGN
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11\' FEB,43m
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DIRECTIONS: One completed application per sign is required. Applicant is
responsible for obtaining a building permit if necessary,
1. PARCEL I.D. OF PROP
2. APPLICANT: (NAME) (ADDRESS)
:re\ {'{\G~c)S (sond T{ QCA.{ S\O[1\ S)
3. OWNER: ~ (ADDRESS)
l3r\(}Iy) (ji'r .(\~ eX- \ q I ~O C t)WHV\-€ rCJl ~
4. SITE ADDRESS OR LOCATION OF SIGN
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5. TYPE OF SIGN: TEMPORARY (21 DAY MAXIMUM DISPLAY) (PERMANE WALLlMARQUEE/AWN/NG/FREESTANDING)
Balloon * Banne,*Business*Changeable Copy Signs*Construction Signs* umllla/e I n Institutional Signs*Lake Service Signs*
Multiple Residential Nameplate Signs*On-Premise Directional Signs*Permanent Indow Sign*Porlable Sign *Subdivision Identification Signs
'05- \0L\-- 004-0
(PHONE)
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(PHONE)
C'\ 5~ -88~ - 858 L
(PHONE)
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6. SIGN DIMENSIONS
(square feet)
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7. TYPE OF CONSTRUCTION
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8. PROPOSED DISPLAY DATES (if applicable)
(Height)
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SIGN PERMITS WIT..L NOT BE PROCESSED IF THEY ARE INCOMPLETE
I hereby certify that I have furnished infonnation 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 permit for just cause, Furthermore, I her y a e that City Officials or a designee
thereof may enter upon the property to perform needed inspections,
~~120
SIGNATURE OF PROPERTY OWNER! AGENT
FOR ADMINISTRATIVE USE
This Application becomes your Si
8/1
Date ~.~. O~
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/ Completed Application ~ ftlb sf'
-;r- Scale Drawing showing location of sign
~~=~~esr~,@ (permit fee is set SfJ~N6- &'lb-N - d-O P
at time of application according to approved schedule~ - 2>~.~
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SUBMISSION REQUIREMENTS
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,
I: \handou IS Isignform.doc
CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE, MN 55372
(952) 447-4230, FAX (952) 447-4245
RECEIPT # 43338
DATE: :J,. }.,?,-Ob
AeceiVedO~~-~~ ~~/.L
the sum of 4' I
for the purpose of
dollars
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$ ?jJ.&eJ
Invoice #
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FAX~ PHONE NO. 9524747543
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