Sign Application - City Of Lakes
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1
2RESET FORM
Development Services
Office Use Only
Customer Service Center
th
Routing#__________________
T#_________________
250 South 4
Street – Room 300
Minneapolis, MN 55415 – 1316
Office
612-673-3000 or 311
Amount$__________________ Permit#__________________
Fax
612-370-1416
TTY
612-673-2157
Development Coordinator______________________________
Signature
Date
SIGN APPLICATION
JOB ADDRESS (PLEASE INCLUDE BUILDING NAME AND NUMBER):
OWNER / OCCUPANT AND PHONE NUMBER:
TYPE OF WORK TO BE DONE: NEW____
TEMPORARY____
SIGN RE-FACE____
ALTERATION____
VALUE OF WORK $______________
SIGN INFORMATION
AND
1-4
EACH APPLICATION MUST INCLUDE THE INFORMATION BELOW
ITEMS
ON THE REVERSE OF THIS FORM
SIGN COPY
(
)
FREE-STANDING SIGN
WALL SIGN
MONUMENT
(
)*
FREE-STANDING SIGN
AWNING/CANOPY
POLE
,
CHANGEABLE COPY SIGN
BANNERS
DYNAMIC
TYPE
*
DYNAMIC SIGN
PROJECTING SIGN
BILLBOARD
r ROOF
_______________________
OTHER
NONE
INTERNAL
ILLUMINATION
*
BACKLIT
EXTERNAL
ft. x
ft. =
sq. ft.
P ROPOSED SIGN D IMENSIONS :
0.00
SIZE / HEIGHT
ft.
H EIGHT ABOVE GRADE ( MEASURED TO TOP OF SIGN ):
T OTAL AREA OF ALL OTHER EXISTING SIGNS / BILLBOARDS :
____________________sq. ft.
SITE INFORMATION
L ENGTH OF WALL UPON WHICH SIGN IS TO BE INSTALLED :
____________________ft.
L ENGTH OF FRONTAGE UPON WHICH SIGN IS TO BE INSTALLED : ____________________ft.
*A separate land use application may be required.
ADDITIONAL INFORMATION: ___________________________________________________________________________
___________________________________________________________________________________________________
I certify that all information provided in this application form and any other information provided by me in support of this application is true
and accurate to the best of my knowledge. I certify that I will comply with all applicable State and local laws and regulations in performing
the work for which this permit is issued, and that I possess all contractor and personal licenses and certificates of competency, if any, that
are required for lawful performance of the work described in this permit. I understand that the issuance of this permit does not imply or
authorize the granting of any such license or certificate of competency, nor the issuance of any business license or professional license.
Homeowners shall not hire unlicensed persons to perform work under any building, electrical, mechanical, or plumbing permit.
SIGNATURE:______________________________________________________
DATE:_________________
COMPANY NAME:
CONTRACTOR LICENSE #:
COMPANY ADDRESS:
CONTACT PERSON:
CITY:
STATE:
ZIP:
CONTACT PHONE #:
EMAIL:
CONTACT FAX#
MAKE CHECKS PAYABLE TO: MINNEAPOLIS FINANCE DEPARTMENT, OR CHARGE TO
ALL MAJOR CREDIT
CVV#
EXP DATE: Mo____Yr___
ACCOUNT#
CARDS ACCEPTED
Version 11.1.15
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