HomeMy WebLinkAboutSign Permit 03-032','i i City of Prior Lake
i I [ I ~ iiliii SIGN PERMIT APPLICATION
~'7o~ ~:c ~¢ni~.eted applicatio7 ~u~ ~ ~
SIGN PE~IITS WILL NOT BE PROCESSED IF THEY ~ INCOMPLETE.
Permit No. <fl~ --05~
1. PROPERTY IDENTIFICATION NO.
4. APPLICANT: (N~,NI~E)~ ' (ADDRESS)
O, t,c,t 6- 0 /os-/
3. ZONING: (,~,__,~
(PHONE)
5. OWNER: (NAME) (ADDRESS)
6. TYPE OF SIGN: (Please circle)
(PHONE)
a. TEMPORARY: Balloon Sign Banner Sign Construction Sign Off-Premise Directional Sign Portable Sign
Streamers and Pennants Street Banner Temporary Sign
PROPOSED DISPLAY DATES: From: / / To: / /
b. ~ER~MA.NEN~T:~.A wning Sign Lake Service Sign Marquee Sign Freestanding Sign Menu Board Sign
~ ~Otl~~rectional Sign Pertnanent Window Sign Sttbdivision Identification Si~
' ~.....__.~
7. SIGN DIMENSIONS:
(Total area) (Height) (Width) (Depth)
/ g,' /,'
10. TYPE OF CONSTRUCTION/MATERIALS:
8. TOTAL WALL AREA:
9. PERCENT OF WALL COVERED BY SIGNAGE:
11. ESTIMATED VALUE OF SIGN:
12. COMPLETION DATE:
A sign plan must accompany this application. Please attach a scaled elevation drawing of the total building front to
which the sign is to be affixed, accurately locating the sign.
If the sign is freestanding, attach a scaled site plan showing the exact setbacks of the sign.
The applicant is responsible for obtaining a building permit for freestanding signs over 6 feet in height.
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 permit for just cause. Furthermore, I hereby agree that City Officials or a designee
thereof may enter upon the property to pertbrm n~eded inspections. ~
SIGNATURE OF PROP~I~;I'-y~WNER/AGENTc---- DATE
This Application becomes your Sign Permit when approved.
FOR ADMINISTRATIVE USE ONLY:
Permit Fee $ - ote: Permit fee is set at time of application according to approved schedule.)
L/ cftv PLANNEI~ OI~IGNEE C ''~'y' 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: ~"-'~'~
24 Hour Notice tbr All Inspections
447-4230 from 9:00 a.m. - 10:00 a.m.
h:\templates\signtbrm.doc
RECEIPT
CITY OF
PRIOR LAKE
16200 Eagle Creek Avenue S.E.
Prior Lake, MN 55372
For the purpose of
dollars
0~~ Account#
Receipt Clerk fo~,the City of Prior Lake