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, City of Orono <br /> Sign Permit Application <br /> _ — Str�et Address: Permit N aio��i33 <br /> �Q� 2750 Kelky Parkrwy Dabe Reosived: . <br /> '��� � Orono,MN 55358 � Totat Fss: A'/��O <br /> O �, O sm�: -�'TP_ <br /> i� � �� M�in: 852-249-4H00 ��"�� ��: <br /> t+'`� � v '�- �' fax: 952-249-4818 ��^ ^ <br /> �t�����'� MsiNnp Addrsas: �;;V`� 4`^� <br /> ��p4 P.O.Box 88 � !L,� <br /> �:-_-� <br /> C IBa ,MN <br /> This application form must be completed in full and a equired iMormation must be submitted. Incomple�a appNcatlons <br /> wlll be returned. (Please print) <br /> (iENERAL INFORMATION• <br /> 3fte Addr+ess: j�'� .St'��Lt�'l/�- �. lVA�OP�t'2-(�� , /°'1�. .��,2- <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: �/ L1-L S1 Cr-/� ;VG a <br /> State Licenae# ��- Expirat�on Date: <br /> Phone(Office): �}�-4y7 -"t S(�O Phone(Cel�: fc*/� �3I-i�3 0 <br /> Maiting Addresa: �, o, Gcax 3�i �o� t,a�.� ri.✓ SS'3��� <br /> Email: 11 au�"Y y� � MGH Sf. �:�-i Fax: <br /> CoMact Person qpp��M js: Cq ctor Homeowner <br /> ��}/1� �k�'� ar�ds ons) <br /> PROPERTY OWNER INFORMATION: <br /> Name: �,S1M �N <br /> Phona(home): Phone(wohc): Cc%�— v3— ��/! <br /> Address: �3�G' Sff�21=1u.✓� Z�2. uJ�9YL��?�.. M.J <br /> Emall: Fsx: <br /> PROJEC7 INFORMATION: <br /> 1.Work Inbnd�d 2.Proposed Sl�n�1 � S.Propos�d slpn/1 4.Slpns bo b�R�mov�d: <br /> (�Sipn Insmllation Spn Face Lenpih: ��� Sipn Faca Urpfh: Number of Sipns; <br /> I J Temporary Sipn(11�t fss) Sipn Face Widlh: �2!�Z,�J Si�n Face Wldfh: <br /> []Slgn Affemation/ Tot�l Squaro Foohgs: .3[?' Talal Squaro Foo�a�e: Square FoobDe: <br /> Face Change Top of Slpn m C�rade: f a• Top ot 3gn to Cirads: <br /> Disdmvs from botbm of Sipn to Dispnce fiom bottom of 3ipn bo <br /> Gr'ads: //t��l Grade: <br /> Materlals: MsbMals: <br /> []Wood [J Wbod <br /> �Plastic (J Plastic <br /> (1 Meml []Met�l <br /> y o�her �-%N . [l othsr <br /> []N/A [)N/A <br /> IIIuminaflon: IOuminatlon: <br /> []Extemal []Extempl <br /> �lrrt�mel [�Irrbmal <br /> []Indirect [j Indirect <br /> [J Otliar []Other <br /> []N/A []N/A <br /> PtEA3E NOTE: A Mlnnesots�Stste ElecMcal Permit Is uired if electrtc�l woric Fs sed. <br /> Estlmat�d Cost: (All work is to be done pe�UBC) S�Iv ������' *Mlnimum permlt t�e=i36.00 <br /> � _ ..�-, , <br /> � f C,� ������ � _ i� �r� ti��c.�_�a�c�_ �l�a .�r���- <br /> � p <br /> 1 i�l�11'1�-�Q�, <br />