HomeMy WebLinkAboutSign Permit 97-098 Temp
City of Prior Lake
APPLICATION FOR SIGN PERMIT
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Permit Noq 7- rf1 f'
White - Applicant
Yellow - City
DIRECTIONS: Spaces numbered 1 thru 10 must be filled in before permit is issued
(Please print or type, and sign where required
1. PARCEL NO. OF PROPERTY:
,j3 -}c;4-00& -()
2. APPLICANT: (NAME) (ADDRESS)
P/216IL LAkf; .sTAT? bl9l1/K
3. OWNER: (NAME) (ADDRESS)
,J)~f3i3/~ )/Ot 1i7?6
4. SITE ADDRESS OR LOCATION OF SIGN
1:A+-/3
(PHONE)
VL/7--d/O/
(PHONE)
t/1J7-d-IO/
(PHONE)
5. TYPE OF SIGN: 'EMPORARY(2I DAY MAXIMUM DlSPLA PERMANENT(WALVMARQUEE/AWNINGIFREESTANDlNG)
Balloo~~usiness*Changeable Copy Signs*Construction Signs*Illuminated Signs*Institutional Signs*Lake Service Signs *
Multiple Residential Nameplate Signs*On-Premise Directional Signs*Permanent Window Sign*Portable Sign*Subdivision Identification Signs
6. SIGN DIMENSIONS
(square feet)
36 d I
7. TYPE OF CONSTRUCTION
l!IIVVL
8. PRO~SED DISPI!Aj'JD TES (if applicable) 7'1
:::J? T. dl - J::() If-~ I c6Jh I S
SIGN PERMITS WILL NOT BE PROC SSED IF THEY ARE INCOMPLETE
(Height)
(Width)
(Depth)
10. Estimated Val~ofSign /....4\
'117D. UU
11. Completion Date
Fr
fr.
;::r
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 perJi rm needed inspections.
9~~S:'77
DATE
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
~omPleted Application
_ Scale Drawing showing location of sign
~Ians and Specs .-0 0
--1L- Permit Fee $;:" (Permit fee is set
at time of application according to approved schedule)
This Application becomes y
/"
/
By /
Sig Permit when approved.
~
it, f/? "'tjCT 7
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 a temporary Certificate of Zoning compliance and allows construction to
commence.
Special Conditions
2f2R-- Cf7 -1)'6 UJ J ~
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24 Hour Notice for All Inspections
447-4230 from 9:00 a.m. - 10:00 a.m.
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CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE, MN 55372
(612) 447-4230, (612) 447-4245
RECEIPT # 31421
DATE .. 't I i ,--l,.:-;
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dollars
for the purpose of
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~ ./Receipt ClerRTor the City of Prior Lake
BUILDING PERMIT #
Building Permit Fee
Plan Check Fee
State Surcharge
Plmb Pmt pp#
Mech Pmt mc#
(Heating only - $65.00)
(Htg & Air - $100.00)
(Fireplace - $40.00)
(Air - $40.00)
SwrNJtr Pmt sw #
Other
Total
BUILDING PERMIT #
1,200.00
700.00
1,500.00
Building Permit Fee
Plan Check Fee
State Surcharge
Park Support Fee
SAC
Plmb Pmt pp#
Mech Pmt mc#
Mech Pmt mc#
SwrNJtr Pmt sw#
Pressure Reducer
Water Meter
Tree Preservation Deposit
SwrNJtr Connection Fee
Water Tower Fee
Builder's Deposit
Other
Total