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P - 84232Planning Division PERMANENT SIGN Perm;t No.: ��� � ti ��i� 763-572-3595 PERMIT APPLICATION 763-571-1287 fax 7� Re�y�� Y. .,'_,��` �', �.� - CITY O� F IDLEY � E c.�vE 1�-i i Dat� c d: DATE: � "1 A LICANT E-MAILi DDRESS: INSTALLATION ADDRESS: _� � I S�� \9 P- T� t c��/ ��N. S�S�3� SU[TE THIS APPLICANT IS: ❑ PROPERTY OWNER ❑ TENANT ❑ SIGN ERECTOR NAME: �• � � {F.i �U� S[GNATURE: PROPERTY OWNER ADDRESS. �\�f I� ' S '� CITY ,�� ,1D l�'P�r C� STATE �L. ZIP �,.%L�Up PHONE: �hI - 3 � J�W CEL'L PHONE: FAX: TENANT NAME: �� ADDRESS: � i E �� SUITE CITY STATE Z[P PHONE: CELL PHONE: FAX: SIGN ERECTOR NAME: N �� �� S ��� �� l.'�'�� � L� ADDRESS: �' � �' (Requires City License) � � � �' S TE CITY STA"iF/�'� ZIP � PHONE: � � CELL PHONE: FAX: /� �s����/ CITY LICENSE: EXPIRAT[ON DATE: APRIL 30 NOTE: Per City Code Sect 214.19, a City license must be obtained by every person engaging in sign erection, construction and repair, including billboazd and electrical si ns. Ci license fee is $35.00. SIGN MESSAGE: �! 7 �� ` -"—i� ��/���iG�. C' �',N T%Z /1 L � ZONING: C_� LENGTH: �✓ � r6 � � S � HEIGHT: � � � 3 ` l0 �Y = TOTAL SQ FOOTAGE: � �-T . !" � FOR MULTIPLE WALL SIGNS (provide additional information): ELEVATION: LENGTH: HEIGHT: = TOTAL SQ. FOOTAGE: ELEVATION: LENGTH: HEIGHT: = TOTAL SQ. FOOTAGE: CONSTRUCTED OF: ILLUMINATED 7 YES IF YES, AN ELECTRICAL PERMIT IS REQUIRED TO WIRE SIGN ESTIMATED VALUE: ❑ Wall -Ete�at�on �irect;on Len th of wall: Allowable s i: ❑ Wall-E�e�at;on D;rect;on Len th of wall: Allowable s ft: ❑ Wall - Elevation Direction Len th of wall: Allowable s ft: ' P lon Setback from ro e line: From drivewa : Off round: /� . a � -� ❑ Monument Setback from ro ert line: From drivewa : ❑ Roof In lieu of lon si n: NOTES: �C'1'c�a�_c' /=l�t:.�,S' Q/a/ �°C 1 LiC/,S�-1^�({ P�/�a":J ���c�:v� � FEE SCHEDULE SIGN PERMIT FEE: ' $3�0.00 IF NOT ILLUMINATED, ADD 5.00 STATE SURCHARGE: TOTAL: THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED The undersigned herby makes application for a permit for the wark herein specified, agreeing to do all wark in strict accordance with the City of Fridley ordinances and rulings of the Planning Division and hereby declare s that all the facts and representations stated in this application are true and correct. - v��1�1� ��i�✓(I<</?� DATE 3� SIGNATURE OF AP .�1NT� � PRINT NAME «/ �� � APPROVED BY � > : � ;� � Y �/"' I � ' PRINT NAME �`���9 � � , , �,�Y� %�- � DATE�� �� �I � � � �, WSPECTION: ❑ FINAL � f • PLEASE NOTE' SEPARA PERMIT IS REQUIRED FOR ELECTI2ICAL RK CITY OF FRIDLEI' - PLA\\ItiG DEPARTMENT 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ��� d _=_ "-o �n Q� �i��j v a� W o� �� E��,d O a�� r� �2 o a c �/, =I o' � ac I e+�i� o �3��� 0 o m c� e+i � aci Z° i � ��s �y � . o o°an a C �'no 486Y�'i i "I �� o �a� .„ `���� N g • �;X^^ C V� 0 P� � g`�' �� Y � -' ��'2 O.d~P� ,���rODC7 N °,[��� 0='03. • • V� OQ� � ON �� d J �� d � P°v`�E�' ���`''''jjj � C�TnMI� �N p��' . in � 01 i m 2 .d. 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