HomeMy WebLinkAboutSign Permit 03-033
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City of Prior Lake
SIGN PERMIT APPLICATION
PelIDit No. O?J - OJy)
DIRECTIONS: One completed application is required PER SIGN.
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE.
1. PROPERTY lDENTIFICA nON NO.
~ 2~~ ~ 900)0
3. ZONING: (r 0
(PHONE)
2. SITE ADDRESS:
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4. APPLICANT: (NAME)
/VIA.l 11) A. J) e
(ADDRESS)
~~ (" I~LAwd 1)/(:c:J
(ADDRESS)
1.f1.j7- i7 b~
(PHONE)
~/lcLe
~E R..tvlt: tAe.L~o ~
5. OWNER: (NAME)
S " "" IS #\ -' .44: t.f
6. TYPE OF SIGN: (Please circle)
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: _1_1_ To: ~_I_
b. PERMANENT' Awning Sign Lake Service Sign Marqllee Sign Freestanding Sign Menll Board Sign
n-Premise Directional Sign Permanent Window Sign SlIbdivision Identification SignC!!all Slgn~
7. SIGN DIMENSIONS:
(Total i~a~"l...f -r
NO ~ 11.-
10. TYPE OF CONSTRUCTIONIMATERIALS:
(Height)
':1
(Depth)
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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 prop ,nd that all construction will conform to all existing state and local laws and will proceed in accordance
with submitted plans. [am aware that the C n r can revoke this permit for just cause. Furthermore, I hereby agree that City Officials or a designee
thereof may enter upon the property to ern inspections.
s
11.- )~....O:3
DATE
This Application becomes your Sign Permit when approved.
FOR ADMINISTRATIVE USE ONLY: hJ bD
Permit Fee $ D ' (Note: Permit fee is set at time of application according to approved schedule.)
,-~(1 a:1;j>( ~i (J\' o-::;'-{)'}
~J 'ClfPLANNEf<3t'"~~ LJJ 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.
SpeciaIConditions:G6'N.Abt? 0-MJNOr -oc. INT[3F2N.t1U~ IL-UU1,/}/"-lA17::;V
24 Hour Notice for All Inspections
447-4230 from 9:00 a.m. -10:00 a.m.
h: \temp lates\si gn form.doc
CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE, MN 55372
(952) 447-4230, FAX (952) 447-4245
RECEIPT # 45730
DATE: I/d' )(1. O?;)
(J-,j:7 r tl'1 ,-) n ~D /.-
Rece.ived of -.-r-. flOC:::. ~ \...A-.rL-,.J~Y',
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the sum of I "--t...I'-- l.~ _. L~ ,L.-, 'IJ I -
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for the purpose of
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, /Receipt Clerk for the City of Prior Lake
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