HomeMy WebLinkAboutSign Permit 97-119 Temp
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White - Applicant
Yellow - City
City of Prior Lake
APPLICATION FOR SIGN PERMIT
Permit No. Cf7 .....It q
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DIRECTIONS: Spaces numbered 1 thru 10 must be filled in before permit is issued
(please print or type, and sign where required
I. PARCEL NO. OF PROPERTY:
<<'6 -90;). ~Ot.../9-)
2. APl}'ICANT: (NAME). (ADDRESS)
~/VJ()f?- (/-}/r{;- :5rlJr~ ~;Vp
3. OWNER: (N~) (ADDR.};SS)
lJt:-138/t: 1Io//l?~,5
4. SITI>7'Zi:7^jNOFSI:N (PHONE)
5. TYPE OF SI N: PERMANENT (WALL/MARQUEElA WNING/FREESTANDING)
BaUoo anne usiness angea e ns Construction Signs*Illuminated Signs*Institutiona!Signs*Lake ServiciSigns*
Multiple es, ential Nameplate Signs*On-Premise Directional Signs*Permllnent Window Sign*Portable Sign*Subdivision Identification Signs
;Jl;ONEl
..7-c2jol
(PHONE)
6. SIGN DIMENSIONS
(square feet)
(Width)
I
(Depth)
10. Es~ed ~Iue of Sign
11. comPIZ Date
I hereby certii)' that! have furnished infonnation on this application which is, to the best of my knowledge, true and correct. I also certii)' 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 thee" Planner can revoke this pe 't for just cause. Furthennore, I hereby agree that City Officials or a designee
thereof may enter upon the property to perfi nee; d' spections.
//-.{; -77
DATE
FOR ADMINISTRATIVE USE
SUBMISSION REQUIREMENTS
~'''''' ^",,''''"''"
ale Drawing showing location of sign
~wns and Specs '1)U
~ermit Fee $. r<:>. . (permit fee is set
at time of application according to approved schedule)
By
This Application bec
Date
This is to certii)' 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 ~.~. ~ff . . .~
Q7--of5 CVyvj ~7'-df&ftn.~/j-
24 Hour Notice for All Inspections
447-4230 from 9:00 Il.m. - 10:00 a.m.
J
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EXPENSE CHECK
75-905/919
-
· fI7 PRIOR LAKE STATE BANK Il16197
1.1 PAY TO THE C;ty of Prior lake $ "''''60.00
ORDER OF
svay and 00/100"''''''''**'''''''''''''''''''''''''''''''''''''''''''''''''*'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' "'*"'.."'''''''''''''''''''.....'''.....**''''''....'''....''''''.....'''
I
I City of Prior lake
DOLLARS
MEMO
ItlJUk' 0d1nthV
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CITY OF PRIOR LAKE
RECEIPT # 31441
DATE:~
----
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dollars
for the purpose of
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$
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---ti' Receipt Clerk for the City of Prior Lake
BUILDING PERMIT #
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#
SwrNVtr Pmt sw#
Pressure Reducer
Water Meter
Tree Preservation Deposit
SwrNVtr Connection Fee
Water Tower Fee
Builder's Deposit
Other
Total
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)
SwrNVtr Pmt sw #
Other
Total