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City of Orono <br /> Sign Permit Application <br /> Street Address: Permit# <br /> (40,0 _ 2750 Kelley Parkway Date Received: <br /> < 0 Orono, MN 55356 Total Fee: <br /> it Staff: <br /> yeMain: 952-249-4600 Comments: <br /> �� Vii 1+i1=C. ,L fax: 952-249-4616 <br /> 0.I;,' • 6~ Mailing Address: <br /> 4 Estio* 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: ‘ '‘e ��.ST" 1,1� 1zAT� , 4'. <br /> CONTRACTOR I APPLICANT INFORMATION: <br /> Name: 15?c--,, J l/WAC-�=5, /"...)C._ <br /> State License# Expiration Date: <br /> Phone (Office): 71,,3-f -psi Phorte (Cell): _6Lz.— z - -• <br /> Mailing Address: 1?$.1ze) //3 - -•--- v, '-- /ii i� 'P.;. i, ss.�.cj <br /> Email: 4/e9/1.14 /, -'d14.:,24,es,ccr- -i Fax: 76 -V o ' // <br /> Contact Person Applicant is: ontractor, Homeowner <br /> /)/1 2- - , .- !2!4-/C171 - -'"(circle one) <br /> PROPERTY OWNER INFORMATION: / <br /> Name: d®`L #J 7 e'"— c,= e C/4 , i0—T,cJ /k3vc.e'�T- .r.�e�. <br /> Phone (home): Phone (Work): .5Z- X73 d1oio <br /> Address: .2c,isio ,o, ,Dia-y z4--r-At 257i.z.14 0120,06 , AU) 5--s--75-4=. <br /> Email: Fax: <br /> PROJECT INFORMATION: . _A=H--)- <br /> 1.Work Intended 2.Proposed Sign'z, 3.Proposed Sign#41- 4.Signs to be Removed: <br /> /SDA.:P.rac7Jj I w.fu. t-ETTE � <br /> Sign Installation Sign Face Length: Z� Sign Face Length: ! 1 Number of Signs: <br /> []Temporary Sign(flat fee) Sign Face Width: Sign Face Width: s <br /> []Sign Alternation/ Total Square Footage: Total Square Footage: 3z, S t" Square Footage: <br /> Face Change Top of Sign to Grade: 7 ' Top of Sign to Grade: air_, r <br /> Distance from bottom of Sign to Distance from bottom of Sign to <br /> Grade: 3' Grade: 33.5i <br /> Materials: Materials: <br /> []Wood []Wood <br /> it Plastic []Plastic <br /> $Metal IrMetal <br /> []Other []Other <br /> [] N/A [] N/A <br /> Illumination: Illumination: <br /> [] External [] External <br /> a Internal [] Internal lb 0.4 V4�6 itA , <br /> [] Indirect [] Indirect <br /> []Other []Other <br /> [] N/A �� 4N/A <br /> V P-L V C .6E15-6D 1)4-1.-L5g' 3 AO <br /> PLEASE NOTE: A Minnesota State Electrical Permit is required if electrical work is proposed. <br /> Estimated Cost: (All work is to be done per UBC) $ * Minimum permit fee = $35.00 <br />