HomeMy WebLinkAboutLA193499THE FOLLOWING INFORMATION MUST BE INCLUDED WITH YOUR APPLICATION:
Payment for amount of permit.
For freestanding/monument/pylon sign - a site plan with setback from property line dimensions 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 façade showing location of sign.
If illuminated or if electrical services are needed, a separate electrical permit is required.
If leased space, need to include a letter of approval from the property owner.
BUSINESS
INFORMATION
Name__________________________________________________________________________________
Address________________________________________________________________________________
City ____________________________________State__________________ Zip _____________________
Contact _____________________________________Day Phone # ________________________________
Email Address __________________________________________________________________________
PROPERTY
OWNER
Name__________________________________________________________________________________
Address________________________________________________________________________________
City ____________________________________State__________________ Zip _____________________
Contact _____________________________________Day Phone # ________________________________
Email Address __________________________________________________________________________
SIGN
CONTRACTOR
Company Name _________________________________________________________________________
Address________________________________________________________________________________
City ___________________________________ State___________________ Zip _____________________
Contact _____________________________________Day Phone # ________________________________
Email Address __________________________________________________________________________
SIGN
DESCRIPTION
Electronic
($100 per sign plus
completion of electronic sign
license, see Page 2)
Permanent
($75 per sign)
Temporary
($50 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 ________________________
Sign Type and Dimensions
Wall Sign: Width ____________ Height: _______________
Square feet _____________________________
Freestanding: Face Width_________ Height____________
Sq. ft__________ Overall Sign Height _________
Setbacks: Front _________ Side ____________
Temporary Width___________ Height ______________
Sign Square Feet______________________
Display location _______________________
Illuminated Sign:
Internally illuminated
Externally illuminated
Not illuminated
Type of Work:
New Sign
Replacement Sign
Alter Existing Sign
Changeable Copy:
No Changeable Copy
Manual Changeable Copy
Electronic Changeable Copy
(Electronic sign will require annual
license review & renewal, see Page 2)
Applicant Signature: ____________________________________________Date:_________________
Applicant Printed Name: _______________________________________________________________
SIGN PERMIT APPLICATION & ELECTRONIC SIGN LICENSE
City of Lakeville – Planning Department
20195 Holyoke Avenue - Lakeville, MN 55044
952.985.4420 - www.lakevillemn.gov
Signcrafters Outdoor
1517 94th Lane NE
Blaine MN 55449
Mike Lawrance 763-571-2995
mike@scoutdoor.com
Pizza Ranch
16995 Kenyon Ave
Lakeville MN
7/21
9/21
10'5'
50
Mike Lawrance
7/15/21
LA193499
SIGN PERMIT APPLICATION & ELECTRONIC SIGN LICENSE Page 2
Electronic Display/Changeable Copy Sign License
By signing below you are certifying the electronic signage m eets 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 sunris e 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 sto p 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 _____
Temporary Sign _____
Electronic Sign _____
Work Type:
New _____
Addition _____
Repair _____
Demolish_____
Replace _____
Alter/Remodel _____
Move _____
Owner:
Public _____
Private _____
Zoning District:
Commercial _____
Industrial _____
Residential_____
Freeway Corridor _____
Required Inspections:
Footing _____
Final _____
Permit Fee:
Permit Fee _____________
Miscellaneous ___________
Total ___________________
Comments:
________________________
________________________
________________________
________________________
________________________
________________________
________________________
Approved by:____________________________
Date:___________________________________
(REVISED JANUARY 2017)
X
X
X $50.00
$50.00
X
C-3
X
19 July 2021
*Permit is valid July 21 to Sept 21.
LA193499