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SIGN PERMIT APPLICATION & ELECTRONIC SIGN LICENSE
City of Lakeville - Planning Departme*t
20195 Holyoke Avenue - Lakeville, MN 55044
952. 985 .442fr - www. lqhpvillgmn. gov
THE FOLLOWING INFORMATION IIUST BE INCLUDEDYI'ITH YOURAPPLICATION:tr Payment for amount of permit.
tr For freestandinf,monumenVp$on sigrn - a site plan with setback from proBerty line dirnensions and art
work with dimensions of sign, and engineered design for footings and foundation.
For wall sign, art work with dimensions of sign and drawings of building fagade showing location of sign
lf illuminated or if electrical services are needed, a separate electricalpermit is required.
lf leased space, need to include a letter of approvalfrom the property owner.
Applicant Signature:
BUSINESS
INFORMATION City Lakeville ,, . Strt* MN Zip -
Phone #
55044
933 L ?I7th Street
Email Address
Contact
PROPERTY
OlfitrIER
Roor"s" 9331 2l7th Street
City Lakeville State MN ZiB 550144
Email Address
FedEx
Contact Leeann Geremer Phone # 8L4-949-8287
SIGN
CONTRACTOR
Contact Kerri Sabol Day Phone #
54115
Company Name )ones Sign Company
Email Address p ermitting@i on e ss i gn. com
zipCityWI
54A-760-2388
De Pere Q*ala
tr Electronic
($100 per sign plus
completion of electronic sign
license, see Page 2)
ts Permanent
{$ZS per sign)
f, Temporary
($SO per event, up to 60 days
per year. Max of one temp
sign displayed at a time.)
Temporary sign displayed dates:
START DATE
END DATE
E Freestanding: Face Width_
Square Feet
4'-g Ll4"
Sq
Sign Type and Dimensions
Height:
Square feet
!ryldth_ Height
Display location
Overatl Sign Height #
Setbacks: Front Side
fl rempomry
Sign
El wall Sign: Width
SIGN
DESCRIPTION
llluminated Siqn:
m Internally itluminated
tr Extemally illuminated
tr Not i[r*rninated
Type of.YYor,k;
m New Sign
n Replacement Sign
m No Changeable Copy
n t/tanual Changeabte Copy
tr Electronic Changeable Copy
(Electronic sign will require annu*Itr AHer Existing Sign Iicense review & renewal, see
Applicant Printed Name:
I r7D
Rooress 1711 Scheuring Road
)
LA189663
SIGN PERMIT & ELECTRONIC SIGN LICENSE APPLICATION Page 2
Electronic Display/Changeable Copy Sign License
By signing below you are certifying the electronic signage meets the following performance standards:
1.The display sign shall not change more than once every seven (7) seconds.
2.The display sign shall not include scrolling, flashing, animation, or other effects.
3.The display must be static and the transition from one static display to another must be
instantaneous without special effects.
4.The display image or message must be self-contained, without continuation in content to the next
image or message.
5.The brightness of the sign shall not exceed 5,000 NITS after sunrise and before sunset or 500
NITS after sunset and before sunrise each day.
6.The sign shall be equipped with an automatic dimmer control or other mechanism that
automatically controls the sign’s brightness to comply with this condition.
7.The display must be designed and equipped to freeze the device in one position if a malfunction of
the electronic display occurs.
8.The display must also be equipped with a means to immediately discontinue the display if it
malfunctions, and the sign owner must immediately stop the electronic display when notified by the
City that it is not complying with the stipulations of this section.
9.The sign shall comply with Chapter 23 of the Zoning Ordinance.
Signature_______________________________________ Date______________________________
Print Name______________________________________ Email ________________________________
EXPIRATION AND RENEWAL OF LICENSE:
•All licenses expire on December 31st of each year.
•License may be renewed only by making application as provided in Section 3-22-4 of the City Code.
•Application for renewal shall be made at least sixty (60) days before the expiration date.
•Each renewal license shall be issued for a maximum period of one (1) year.
•Annual license renewal fee is $50.00
Office Use Only
Sign Permit Type:
Permanent Sign _X__
Temporary Sign _____
Electronic Sign _____
Work Type:
New _X___
Addition _____
Repair _____
Demolish_____
Replace _____
Alter/Remodel _____
Move _____
Owner: Public _____
Private __X_
Zoning District:
Commercial _____
Industrial X___
Residential_____
Freeway Corridor _____
Required Inspections:
Footing _____
Final _X____
Permit Fee:
Permit Fee _$75_______
Miscellaneous ___________
Total _$75_____________
Comments:
* Email kjenson@lakevillemn.gov
after installation for final inspection.
________________________
________________________
________________________
________________________
________________________
________________________
Approved by:____________________________
Date:_7 April 2021___________________
(REVISED JANUARY 2017)
LA189663
LA189663
LA189663