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. City of Orono
<br /> Sign Permit Application
<br /> • — Street Address: Permit#
<br /> /�0.4 2750 Kelley Parkway Date Received:
<br /> Orono, MN 55356 Total Fee:
<br /> 0, _ Staff
<br /> �i --.ae Main: 952-249-4600 Comments:
<br /> q,` [ 4 fax: 952 249 4616
<br /> `� !J/'
<br /> Mailing Address 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: OgGaljD 4_ ef; 7,D`t4D teJ4 x.d, - a4 /'. 417e). cvL= T"^
<br /> CONTRACTOR/APPLICANT INFORMATION:
<br /> Name: s,'c,J �..4/.4_e- 6 3, "xi e, ,
<br /> State License# Expiration Date:
<br /> Phone (Office): 76".', yzfj. /599 Phone (Cell): 6,12 , 2' 9 i, —.7.,
<br /> Mailing Address: /7y2e:.) ,,J� (7"" ,eie, / -,4144,7--- 6:-A%P'e3e/ 4/ x.34
<br /> Email: zr),.-4r.�", .=, ./.9/-4/ gJe : e xfax: 763= 94?.
<br /> Contact Person Applicant is: r1 Homeowner
<br /> M4' /2 , -/file- (circle one)
<br /> PROPERTY OWNER INFORMATION:
<br /> Name: Vcr)4.-'Alit S eaF , 4'7'lc/1 .l1.e�-T/bitl.4L.. 4c
<br /> Phone (home): Phone (work): GSZ - q'e5 - /•2 /--
<br /> Addre7',�� ~,re,, 7- /'- li- Vx2.� 7Jr ' y. 1-.-40.4- //11.€.7S- Sys/
<br /> "'Email: r1.72-''' /,)/& i-2J9 , c)ro' Fax:
<br /> PROJECT INFORMATION: r
<br /> 1.Work Intended 2. Proposed Signal 0 3. Proposed Signer G T 4.Signs to be Removed:
<br /> 6'444- 4_&-T-TES`' i• i+tiiu C-
<br /> v mUT 3,rC-�
<br /> /
<br /> 104 Sign Installation Sign Face Length: /3 Sign Face Length: iz Number of Signs:
<br /> []Temporary Sign(flat fee) Sign Face Width: 2.5 ' Sign Face Width: i•+'
<br /> X Sign Alternation/ Total Square Footage: Sz. 7 Total Square Footage: 46 Square Footage: ,25
<br /> Face Change Top of Sign to Grade: 34, Top of Sign to Grade:
<br /> Distance from bottom of Sign to Distance from bottom of Sign torc c,. Tyre:: A- I
<br /> Grade: 3",5 Grade: 3 _ .5-1-1 sir
<br /> Materials: Materials: /Lio /t..-c-L ctit
<br /> P 44/ []Wood []Wood
<br /> [] Plastic 4019 Plastic _
<br /> :Pal y ynC [� ] Metal 5f Metal
<br /> ]Other H]Other
<br /> 4.7-1:--7)e4-- [] N/A H N/A `J'6.4iv PL
<br /> Illumination: Illumination: r_A- -C �S rfi
<br /> Ej/G•t) TYf C []External r,,U H External �`a_/�
<br /> []Internal ] Internal 5/F ,[l!i�! • /LL L'4/4
<br /> ©/, []Indirect 11-"I"
<br /> H] Indirect �a
<br /> 5 r T/PG,� []Other []Other m Di)AMA � �K
<br /> //�� N/A [] N/A ��ie7�1-Y
<br /> /��t� 1,144_ `�r? f ,),eiL 1/i4-t-U
<br /> ��° z'G' 1/4-4-1-14. Svc.e'
<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) $ 1 a,' ,1•;" * Minimum permit fee = $35.00
<br /> # 3502 1
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