2012-01173 - temp sign - Laserfiche WebLink

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� ��ty of Orono Temporary Sign Permit Appiication �--� Mailing Address: � � � �.- �� �•Qv� � PO Box 66 Permit number: �(; � �' � Crystal Bay, MN 55323-0066 Date received: I � - I -�� 7i �� `` � �� v �� Received b I C, � , a ��.�a Street Address: Y� �_,� �il ��'�,n ��T ��/� 2750 Kelley ParkwaY Permit Fee: �35.00 ��kEsxo�j�� Orono, MN 55356 � �� If mailing, add $2.00 Main: 952-249�600 Fax: 952-249-4616 www.ci.orano.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applicati ns will be returned. (Please print) BUSINESS INFORM I �� Name: � �� (�J I Address: �� Cit : ZIP: Contact Person: Phone: Email and/or Fax � APPLICANT (RESPO SIBLE PARTY): � '`� - Name: � rJ�- Mailing Address: Cit : l�t. ZIP: Contact Person: Phone: SIGN COMPANY / OWNER (IF NOT SAME AS BUSINESS): Name: Address: City: ZI P: Contact Person: Phone: PROJECT INFORMATION: Type of Sign: Size of Sign: Location of Sign: Dates Sign to be Displayed: ❑ Portable Reader board - � � " � Z ❑ Banner �J� �� 1 � ❑ A-Frame � �75 ` - y ❑ Balloon � ` '`�• �Z. '�'� ❑ Other(specify) � Z. • � ' � Z- For signs not atfached to a building, provide locafion sketch on back of application. APPLICANT ACKNOWLEDGEMENT: • Violation of City Ordinances is a misdemeanor. Each day the violation continues in existence shall be deemed a separate violation; • The City may, without notice, remove any temporary sign erected in violation city, state or federal regulation; • The si n s), si n sup orts or rta stand st be removed from public vi at the end of the permit period. Applicant Signature: � Date: ,� � ,� For Multi-Tenant Buildings: � Property Owner or - " 1�� ,, / -��- 2 Manager Signature: �tf Date: � % , �� -�- Printed Name of Property Owner or Manager: (� � 2 �'�3 �5/� ` Phone Number: Email and/or Fax Number: