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1 City of Orono <br /> Temporary Sign Permit Application <br /> Mailing Address: Permit number: <br /> �,0,- PO Box 66 <br /> O0 <br /> Crystal Bay, MN 55323-0066 Date received: <br /> "�` Received by: <br /> A >, Street Address:ye, <br /> Aiiz_ titi 2750 Kelley Parkway $35.00 <br /> � ii4,to o Y Permit Fee: <br /> 9gESH_____ Orono, MN 55356 <br /> If mailing, add$2.00 <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> BUSINESS INFORMATION: F,� <br /> Name: -{-�{,irVec4 t- c A U FQ 1 rvod5 CoDkpora `,Je, tc_ <br /> Address: �1) l,a.), (A)ci-.yzci, R 1 vat_. City: LollLC�-K�, ZIP: S-5-3-5-6:, <br /> Contact Person: kf',( 14 , 1>e,;(-)la vx <br /> Phone: 615 345--330 0 ( <br /> Email and/or Fax - i-,Cic'Acw-1 VIQYve,S1 iMe2nVl-coo1D c16-;)- 34s -3303 <br /> APPLICANT(RESPONSIBLE PARTY): <br /> Name: C Sa- aS a QP,) <br /> Mailing Address: City: ZIP: <br /> Contact Person: <br /> Phone: <br /> SIGN COMPANY/OWN (IF NOT SIAME AS BUSINESS): <br /> Name: <br /> Address: r 3,1Cf 6 Warg 1 agi City: bi 'r za(, ZIP: -J � i <br /> Contact Person: <br /> Phone: `i 73- 404-22cd <br /> PROJECT INFORMATION: <br /> Type of Sign: Size of Sign: Location of Sign: Dates Sign to be Displayed: <br /> ❑ Portable Reader board - �� L ,,p�, , <br /> yl Banner 4� 3" X /0' k l 5,'fie- 4 ixid t'` �p l o ci <br /> ❑ A-Frame f I <br /> E Balloon <br /> ❑ Other(specify) <br /> For signs not attached to a building, provide location sketch on back of application. <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Violation of City Ordinances is a misdemeanor. Each day the violation continues in existence shall be deemed a separate <br /> violation; <br /> • The City may, without notice, remove any temporary sign erected in violation of city, state or federal regulation; <br /> • The sign(s), sign supports or portable stand must a removed fro .c view at the end of the permit period. <br /> Applicant Signature: r, -= / Date: 0/:g/`U <br /> For Multi-Tenant Buildings: <br /> Property Owner or /1A/_ A n g,� <br /> Manager Signature: �`J'" '�'` II� rr __ Date: <br /> Printed Name of Property Owner or Manager: x- i- , jl.Ccln <br /> Phone Number: c/�� 345--- CO Email and/or Fax Number: . _• 41QYJesf • 1 . <br /> q5 345-3363 <br />