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� • , <br /> City of Orono <br /> Sign Permit Application <br /> Street Address: Permit# o�DlO� �/�� <br /> O���O 2750 Kelley Parkway Date Received: � � /p— <br /> Orono,MN 55356 Total Fee: <br /> Staff: <br /> Main: 952-249-4600 Comments: <br /> � � �" fax: 952-249-4616 <br /> � ` p�� Mailing Address: <br /> t'qftE$Hp4�' P.O. Box 66 <br /> Crystal Bay, MN 55323-0066 <br /> This application form must be completed in full and all required information must be submitted. Incomplete applications <br /> will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Site Address: 34 3:} :S 1,�����n� 1�r=�v-�,aJc.��;,� f�N ; a53'�1 0 <br /> , • <br /> CONTRACTOR /APPLICANT INFORMATION: <br /> Name: ��:;-a \w:,f._. - L�1-.v-��^ L�r,�s� <br /> State License# � Expiration Date: <br /> Phone (Office): �'�;",�-;�.1)�- �>>')�, Phone (Cell): (,�Z-����-•��LZ3 <br /> Mailing Address �yy �a�,r,.,�,� � �� .- • 3�r�, � <br /> � C� L7• ►v� � tw�r���'c,�� n'l`J SS`"137 <br /> Email: �.'r;-.,�� 3 �. iY,.sn. �:�.. Fax: �-�a�•�.7"���3�')S� �..,...._ .. <br /> Contact Person `� Applicant is: Contractor Homeowner ' '�:,,�,,�.,, <br /> Acc'� �G�r�.z"' (circle one) <br /> PROPERTY OWNER INFORMATION: <br /> Name: �5: _.:� ..1.,.��:..,�,-,-,:� �..,�.c, �L< <br /> Phone (home): Phone (work): (,,I�--y�t�-�)4� <br /> Address: ��`i�Z\ ;''�„- �e L,�„�. <br /> Email: S� ��_r,�L��'��.\ec��Y, Fax: <br /> PROJECT INFORMATION: <br /> 1.Work Intended 2.Proposed Sign#1 3. Proposed Sign#A;!, 3.Proposed Sign#1;3 <br /> i � � <br /> Sign Installation Sign Face Length: �' Si Face Length: �_ Sign Face Length:; � <br /> []Temporary Sign(flat fee) Sign Face Width: � Sig Face Width: y ' Sign Face Width`�y�,�L ; <br /> (] Sign Alternation/ Total Square Footage: 3t., Total quare Footage: ` Total Square Footage: ' <-_7 <br /> Face Change Top of Sign to Grade:� Top of ign to Grade: Top of Sign to Grade: "1C` <br /> Distance from bottom of Sign to Distance rom bottom of ign to Distance from bottom of Sign to <br /> Grade: g Grade: Grade: �� <br /> Materials: Materials: Materials: <br /> []Wood []Wood []Wood <br /> []Plastic [� Plastic []Plastic <br /> []Metal ] Metal [] Metal <br /> �p�Other���_ �;Other � �Other L�!p,icai <br /> [j N/A []N/A []N/A <br /> Illumination: Illumin on: Illumination: <br /> [] Extemal [] Exte al [] External <br /> [] Internal [] Int nal � [] Internal <br /> [] Indirect (] In irect [� Indirect <br /> []Other [] ther []Other <br /> ;�N/A /A �tj N/A <br /> PLEASE NOTE: A Minnesota State Electrica�Permit is re uired if electrical work is ro osed. <br /> Estimated Cost: (All work is to be done per UBC) $ ` , * Minimum permit fee = $35.00 <br /> '� � � � � <br /> ��J�i�j —' ���.��J (�(� .� <br /> �G._, <br /> � � <br /> `f�i(�►1�� _ LL�C'•t.�(.� <br />