HomeMy WebLinkAboutSign Permit 97-136
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City of Prior Lllke
APPLICATION FOR SIGN PERMIT
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Wbite,Appli,G!UIt
Yellow - City
DIRECTIONS: Spaces numbered 1 thru 10 must be nlled in before permit is issued
(please print or type, and sign where required
Permit No.
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1. PARCEL NO. OF PROPERTY:
:::J<5-CjD ~-Ot...Jd-O
2. APPLICANT: . (NAME)
)JOrtJ ~IJiSf S':)n
3. OWNER: . .. ... (NAME)
~ S S ;tJ 3gD:J () ~ N'{Ollt t 6111d
4. SITE ADDRESS R LOCATION OF SIGN
-
tN1JLlin I yt;('
(ADDRESS) (PHONE)
CD - 31d WLak<3t. r11fIS, rl1# ~d3-7d9)
(ADDRESS) (PHONE)
S-{-. ltJJ; ~ g y Ie M
(PHONE)
Ifo7D5
5. TYPE OF SIGN' TEMPORARY (21 DAYMAXIMUM DISPLAY) 'RMANE :4 QUEElAWNING/FREESTANDIHG)
Balloon * Ban"e~hil1lgeable Copy Sig1lS*Construction Sig1lS*IUuminated SigllS*Institutional Signs*Lake Service SigllS*
Multiple Residential Nameplate SigllS*On-Premlse Directional Sig1lS*Permanent W'mdow Sign*Portable Sign*Subdivision Identification SigllS
6. SIGN DIMENSIONS
(square feet) (Height)
dr' - lJ. II
7. TYPE OF CONSTRUCTION
(Width)
5"
(Depth)
ut1erS
10. Estimeed Value of Sign
VI' lS, .3M
11. Completion Date
. .J
8. PROPOSED DISPLAY DATES (if applicable)
SIGN PERMITS WILL NOT B
OCESSED IF THEY ARE INCOMPLETE
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I ~ereby certify that I have furnished information on this applic on 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 , and th . 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 Ian e IS. permit for Jusi- cause. Furthermore, I hereby agree that City Officials. or<a designee
thereof may enter upon the property to perfo eoed ins io.
FOR ADMINISTRATIVE USE
SUB SSION REQUIREMENTS
~Pleted Application
~~ Drawing showing location of sign
-Vlans and Specs
~ Permit Fee $ 4;? '"1) (permit fee is set
at time of application according to approved schedule)
This Application b
By
Ci P anner or designee
Date I O/3P/Q7
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.
24 Hour Notice for All Inspections
447-4230 from 9:00a.m. . 10:00 a.m.
Special Conditions
6f # 97-575 ) $l.L ql-(~S--.
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF '2- ~
ZONING COMPLIANCE ~~
AND UTILITY CONNECTION PERMIT Permit No.
DATE RECEIVED
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DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
63'1
g'P '~7 ~
57.5
q1
1. While
2. Pink
3. Yellow
Flle
Oty
Applicant
1. DATE
10' j(j '17
y;- 50
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
:p~
BL~/ /I. Jy
1~7()
12. NO. OF STORIES
LOT
J V-
.Q1t~
PID
~L;. '1();)..' 0((;;"
13. TYPE OF CONSTRUCTION
A.A
,
ADDITION
4. OWNER
(Namey(J~
(Name)
(AdW~ .1..
AJ'~..
IV' I
(Address)
1 (r..~ (Tel. No.)
r..~~,L/
(Tel. No.)
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5. ARCHITECT
6. BUILDER
(Name)
(1 (5Y j vI s1-
(Address)
$,-;' [;n [h
14. FLOOR AREA APPORTIONMENT USE
w
DeckLJ
Finish Attic LJ
Re-ro Ing LJ Porch LJ
Re-siding LJ Finish Basement LJ
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction LJ
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES
Sq.FI.
10. CULVERT SIZE
Yes No
PERTY DIMENSIONS
Depth
17. COMPLETION DATE
I hereby certify that I have fumished 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
building official can revoke this permit for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
Signature
License No.
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
o
USE OF BUILDIN",
lV\ ~ UA""" lA
f
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TYPE OF CONSTRU~ON: I I III IV V
Occupancy Group A ~ E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
City:
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(;l\ v)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
This
By
ermn ....................... $
n Becomes Your Building Permit When Approved.
Date 10 -SO
q1~1~~
q1~1;~
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LJ ENERGY DATA LJ
PILING LOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS LJ SETS
SURVEY LJ COPIES
PLOT PLAN LJ
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Ham ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
-
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in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as
a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of
Date
24 hour notice for all inspections 447-4230
Special Conditions ij any
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This drawing is the property of
~
Customer
HEAL TH5Y5TEM5
Address
Scale
NOTED
Drawn By
55
Salesperson
GF
Date
9/25/97
Revisions
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NORDQUIST
COMPANY
SIC N
I N C .
City
PRIOR LAKE
State
Customer Approval
Date
312 WEST LAKE STI~EET
MINNEAPOLIS, MN 55408
6128237291
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