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Home My WebLink AboutLA209443 THE FOLLOWING INFORMATION MUST BE INCLUDED WITH YOUR APPLICATION:  Please complete a separate application form for each sign.  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. SIGN LOCATION 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) (1000.4114)  Permanent ($75 per sign) (1000.4114)  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: 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 & ELECTRONIC SIGN LICENSE APPLICATION City of Lakeville – Planning Department 20195 Holyoke Avenue - Lakeville, MN 55044 952.985.4420 - www.lakevillemn.gov 7200 Lakeville Blvd Lakeville MN 55044 marketing@appleautos.com marketing@appleautos.com GULBRANDSON REAL ESTATE LLLP Apple Valley Ford Pro 7200 150TH ST W Apple Valley MN 55124 Mark H. Gulbrandson 952-435-2485 N/A 612 SIGNS 7435 Washington Ave S Eden Prairie MN 55439 Lisa Murhpy-Salvador 612-503-5033 lisa@612signs.com Sign 2 (B) 187"55" 71.5 1/17/2023 Lisa Murhpy-Salvador LA209443 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 APRIL 2022) X X X $75.00 $75.00 X 20 January 2023 C-2 *Email kjenson@lakeville.gov after installation for final inspection. Name: Signature: Date: APPROVED APPROVED AS NOTED SALESPERSON: WS DRAWN BY: WS SCALE: AS NOTED REV: - 222 7435 Washington Avenue South7435 Washington Avenue South Minneapolis, MN 55439Minneapolis, MN 55439 sales sales ||William SalvadorWilliam Salvador phonephone ||612.503.5030612.503.5030 emailemail ||william@612signs.com william@612signs.com 7435 Washington Avenue South Minneapolis, MN 55439 sales |William Salvador phone |612.503.5030 email |william@612signs.com LOCATIONCOMPANY CONTACT PHONE EMAILCLIENT COMPANY APPLE AUTO CONTACT Chris G. PHONE 952 836-9321 EMAIL LOCATION ADDRESS All design, manufacturing, reproduction, use, and sale of this document is strictly prohibited without the written consent of 612 SIGNS. This document is submitted under a confidential understanding that the recipient assumes custody and agrees that the document and any part of its content is not to be copied or reproduced, nor any of its contents be revealed in whole or in part to other parties, except where agreed upon by 612 SIGNS and recipient. In addition, no design features unique to this document may be incorporated in any other project except by agreement between 612 SIGNS and the customer. Sections: Face Lit Channel letter N.T.S. SIGN 2: Face lit letters.187’x55”. 71 1/2 sf N.T.S.12’12’12’19’19’19’Quantity: Mount: Wall Mounted Size H x W: 55” x 187” Notes: Face lit channel letters mounted on a raceway 1 3/16” acrylic face111 Material & Finish Schedule 3” white aluminum return 222 1” trimcap 333 6” raceway painted555 .040 aluminum back 444 to match building color Principal LED LEDs and 666 60W 120V/12V transformers Sign Type BSign Type BSign Type B 3”5"54.97”55” 187” LA209443