HomeMy WebLinkAboutSign Permit 04-010 American Family Ins wall
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City of Prior Lake
SIGN PERMIT APPLICATION
PermitNo.~D
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eted application is required PER SIGN.
SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE.
1. PROPERTY IDENTIFICA nON NO.
2. SITE i4DRESS:
\ \<:60 C ()tI\l1VY\~YLe.
4. APPLICANT: (NAl'1E)
SJI11d 1Y{iCl )11
5. OWNER: (N )
_r\~~{)Ct\V\ .h;:w\\lV\ tYl41/fClVlU
6. TYPE OF SIGN: (PI'ease circle)
A\.J.€ 5.J\+e Q0\
(ADDRESS) (PHONE)
I GID t. ClIft: t2d ) p-JtV'1Sv,'!Ll mJJ &s?/61 ft62.<l1tt ~MJ. (
(ADDRESS) (PHONE)
~\<6U [OW1WUY'U' ~~ SUlk' d01,~6( ~
/
25-194-604-0
3. ZONING:
( 06ci);Z6?6 -
GO
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: --.1_1_
b.
PERMANENT: Awning Sign Lake Service Sign Marquee Sign Freestanding Sign ...Menu Board Sign
On-Premise Directional Sign Permanent Window Sign Subdivision Identification Sign 0.all Sign ~
7--.
7. SIGN DIMENSIONS:
(Total area)
;:) ?, ~/
(Width)
Q'9"
10. TYPE OF CONSTRUCTIONIMATERlALS:
(Height)
;)'/('
(Depth)
8. TOTAL WALL AREA: ...5 () 0
r
1(" X
'. . .
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 infonnation on this application, which is, to the best of my knowledge, true and correct. I also certify that [ am the owner
or authorized agent for the above-mentione~rope..rty, and tha. t. all..c.on. strUction will confonn to all existing state and lo..calla. ws and will proceed in accordance
with submitted plans. I am aware that tlJ{ C nl\er can revoke this pennit for just cause. Furthennore, I hereby agree that City Officials or a designee
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thereof may enter upon the property to. rfo ryeyJ.~n. s..p..ectiO. n.s;,"_. . /. ...r
./' t.~_~'Yl-,;Lf //,.2 ~/Cd,tl .
IGNA TURE O;PROPER~Y OWNER! AGENT DA nl'
/-
This Application becomes your Sign Permit when approved.
FOR ADMINISTRATIVE USE ONLY: ~ 00
Pennit Fee $ . ~ (Note: Pennit fee is set at time of application according to approved schedule.)
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CITY PLANNER OR DESIGNEE
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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:
7-
~
24 Hour Notice for All Inspections
447-4230 from 9:00 a.m. - 10:00 a.m.
h:ltemp !ateslsign fonn.doc
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CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE, MN 55372
(952) 447-4230, FAX (952) 447-4245
RECEIPT # 47514
DATE
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for the purpose of
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