HomeMy WebLinkAboutLA204977----- --
SIGN PERMIT & ELECTRONIC SIGN LICENSE APPLICATION
City of Lakeville -Planning Department
20195 Holyoke Avenue -Lakeville, MN 55044
952.985.4420 -www.lakevillemn.gov
THE FOLLOWING INFORMATION MUST BE INCLUDED WITH YOUR APPLICATION: □Please complete a separate application form for each sign.□Payment for amount of permit.D 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 fa9ade showing location of sign.□If illuminated or if electrical services are needed, a separate electrical permit is required.□If leased s ace, need to include a letter of a roval from the ro ert owner.
SIGN
LOCATION
Address 0
City /d,l (Le ,61\:(-< State __ --'-___ Zip -=---'-q_·(J---'4Ytf-----Contact Jv1fl, Y14 WVl V)f).JL/Day Phone# UJ) Z---$D 0-fO d::I
Email Address bJ'.-0 d1 • k lA V1 vie«@ t/MY '-I\ e»J, {) CE)
PROPERTY Address ___ ----1,.�t.......Jl...:.!..1.tl...Ll..:��...!..:.....;=-=---��------�-=----------
OWNER City_-4,,.L-p:.,....==½:u.,.,.-'----J1-----,,.,..--- ___ tv ____ Zip > '15 j
SIGN
CONTRACTOR
SIGN
DESCRIPTION
Contact-1..:-w....v=-=-=,t---!'���.......::c...---t-OJ c;-z. -J-'14 ·-0 3 i;;'
Email Address □Electronic Sign Type and Dimensions
($100 per sign plus t, completion of electronic sign w1i1 Sign: license, see Page 2) <L/_ Width __ fr:: ____ Height: ______ _ Square feet ____________ _ (1000.4114) □Permanent
($75 per sign) (1000.4114) r:tl Temporary
($50 per event, up to 60 days
per year. Max of one temp
sign displayed at a time.) (1000.4114)
Temporary sign displayed dates:
ST ART DATE l, "7.--
END DATE
Illuminated Sign:
□Internally illuminated□Externally illuminated□Not illuminated
□Freestanding: Face Width ____ Height. _____
rtJTemporary Nsign
Sq. ft Overall Sign Height ___ _ Setbacks: Front Side -----
<I 4' Width J) I Height ___ ......_ __ _ Square Feet ___ �.,,..--Z�'-' ____ _ Display location � of-
�
0--\-e '7 �� -,er
Type of Work: Changeable Copy: D No Changeable Copy □New Sign□Replacement Sign□Alter Existing Sign
D Manual Changeable Copy
D Electronic Changeable Copy
(Electronic sign will require annual
license review & renewal see Pa e 2
Applicant Signature: ---41-+1-���4/L--.j�l-+-l-,�!.....<:..:=-------Date: 1 le\
Applicant Printed Name: V\Fq? >f ¥zll N \J:E u__,, 1 MaKlR,b vt§
ebCl\JGia_ fRo PCT-,y� l!AAjJ��
08/08/202210/07/2022
LA204977
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 _____
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 4 August 2022
X
X
* Temporary sign to be placed on the
trailer on site.
952-208-9988developed by managed by
pillarsseniorliving.com/lakeville
LEASING GALLERY NOW OPEN!
LA204977