HomeMy WebLinkAboutSign Permit 97-112 - Lemke Chiropractor
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City of Prior Lake
APPLICATION FOR SIGN PERMIT
PennitNo. 'f1-)1 ~
DmEcnONS: Spaces JlUIfibeted 1 thru 10 must be filled in before perInit is issued
(pleasepdnt or type, and sign where required
1. PARCEL.. NOjF PROPER.T.. Y:
d 5....7. Z?-OI.:J.- J
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z. '"'. p. L.\CANT: (N..wE) (A))D.)U!SSl .>/1" 6,,/c tu4y ..J"rJ.c (PHoNE)
/~~I tv. LQm~. . .f1../~J.~j.~ /H;,. . ~...l) 1/Yb-,J;J,,-,-
3..0WNER: .... (NAl\iE). ... ....' ..... . ... (ADDRESS) 1/ J(pHONE)
. ~~ / W. L.G>JtI1 k~ (f/ )) ~yo -;;1.:J.5 }-
4. SITE ADDRESS OR LocAtION OF SIGN ../ (PHONE)
5. TYPE OF SIGN: TEMPORAIlY(21DAYMAXIMUMDI$PUY) 'ERMANE ~ 'AIlQUEE/AWNINGlFllEEStANDING)
Balloon* Bannf!r~*Changeable Copy $igns*Consttuction SigllS*IUuntilfate ,gns*L tional signs*Lake Service Signs*
Multiplf! llesidenti;;nv;;:;plateSigns*On"Prenrise Directio"al Signs*Permanent Window Sign*PortableSign*Subdivision Identification SIgns
6. SIGN DIMENSIONS
(square feet)
5y 3'
7. TYPE.OF CONSTRUCTION
WDt:> tI ~ &~>'"
8. PROPOSED DISPLAY DATES (if applicable)
(Height)
(Width)
/J'I
(Depth)
~9//
10. Estimated Value of Sign
/21KJ.IJO
11. COlDpletion Date
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SIGN PERMITS WILL NOT BE PROCESSED IF THEY ARE INCOMPLETE
c; best of my knowledge, true and correct. I also certifY that I am the owner
Il conform to all existing state and local laws and will proceed in accordance
r just cause. Furthermore, I hereby agree that City Officials or a designee
/o-~7-J7
DATE
FOR ADMINISTRATIVE USE
SUBMjSSIONREQUIREMENTS
~Pleted Application
~DraWing shoWing location of sign
~~s and Specs ..
~e~it Fee $ ~ ~.I ~ennit fee is set
at time of application according to approved schedule}
v
By
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
cOlDffience.
SpooloJ Condi_O':? la~ C u f' rt en -0 17
ity Planner or designee
Date 11/4/17
24 Hour Notice for All Inspections
447-4230 from 9:00 am. - 10:00 a.m.
Received of
the sum of
for the purpose of
CITY OF PRIOR LAKE
16200 EAGLE CREEK AVE SE
PRIOR LAKE, MN 55372
(612) 447-4230, (612) 447-4245
RECEIPT # 31439
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DATE: I, 1.1 7 -I-
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dollars
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~Receipt Clerk for 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)
SwrlWtr 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#
SwrlWtr Pmt sw#
Pressure Reducer
Water Meter
Tree Preservation Deposit
SwrlWtr Connection Fee
Water Tower Fee
Builder's Deposit
Other
Total
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LEMKE PROFESSIONAL BUILDING
5118 GATEWAY BmEET
PRIOR LAKE. MINNESOTA
EXTERIOR ElEVA11ONS/ BUILDING 8ECT1ON8
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