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c., t <br /> City of Orono <br /> Sign Permit Application /- <br /> Street Address: Permit# 6201 I— d ool <br /> O 2750 Kelley Parkway Date Received: .(3/ 1 I <br /> Orono, MN 55356 Total Fee: <br /> 0 0 Staff: <br /> µ Main: 952-249-4600 Comments: <br /> '� ` , ti fax: 952-249-4616 <br /> �� �, 1I�' .�G� Mailing Address: <br /> -4kEsso/ 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: .o Vii acs/ ,&JAYz,4-n Z3s1-40 <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: -S/EA-/ ''�i,41-E /AJl_ , <br /> State License# Expiration Date: <br /> Phone (Office): 7i,3_ 2.,B- I s'9 j Phone (Cell): 6 l i- Z? /S-97 <br /> Mailing Address: /7/21- __D f/3%1 -rhe" ack) /2141-Pi.4. ' i1,/ - Aid -s 7 <br /> Email: /v/arK r e'.sil ili ni W1es , rG04.1 Fax: 74,3- vz. -1 S Z <br /> Contact Person /•9 ,, # ,c,1plcT Applicant is: Cont arc aT� eomeowner <br /> e ) <br /> PROPERTY OWNER INFORMATION: L4 <br /> Name: 434.d.uTeE125 of 4711 ? 1c✓�- / k .�i-0r m*I4. - <br /> Phone (home): Phon (work): ej,S - 4173 -6(31.0 <br /> Address: mac, f1.0 ft) a..1/41244 779 i ,,e, Q'oaI./r6 rvuJ <br /> Email: / Fax: <br /> 1 <br /> PROJECT INFORMATION: <br /> 1.Work Intended 2. Proposed Sign#1 3. Proposed Sign#a 4.Signs to be Removed: <br /> WAyt*rn ir�k. <br /> ?Alio .27) /3,24,(,).t: gp 44,42-4 -- <br /> [j Sign Installation Sign Face Length: S Sign Face Length: 5 ' Number of Signs: <br /> [1 Temporary Sign(flat fee) Sign Face Width: =S Sign Face Width: 5 <br /> Sign Alternation/ Total Square Footage: a51 Total Square Footage: a5 Square Footage: <br /> Face Change Top of Sign to Grade: & I Top of Sign to Grade: (o ' <br /> Distance from bottom of Sign to Distance from bottom of Sign to <br /> Grade: 1 1 Grade: / ' <br /> Materials: - Materials: <br /> []Wood 'i NG w []Wood 't'"IC t� <br /> C. <br /> / <br /> [] Plastic 4-C - [] Plastic PACO- <br /> 1.1 Metal [d]Metal <br /> []Other_ []Other <br /> [] N/A [] N/A <br /> Illumination: Illumination: <br /> [] External [] External <br /> InternalInternal M% <br /> [] Indirect �� — I. <br /> [] Indirect N 11'1' <br /> []Other []Other <br /> {#N/A _ [ftN/A <br /> `v <br /> VASE 500 - a//* i 5D0 <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 /> :. -1 tI4 �`�� , ei 5 11-%' 10,x' <br /> ` : <br />