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City of Gem Lake Building Permit Application 06/29/2021 - Page 1 of 1 City of Gem Lake Heritage Hall 4200 Otter Lake Road | Gem Lake, MN 55110 651-747-2790/92 | 651-747-2795 (fax) E-mail city@gemlakemn.org Sign Permit Application Application: New Renewal Temporary (from to ) Property Information Business Name: Property Owner: Project Address: City: State: Zip: Home Phone: Cell Phone: Sign Contractor Information Sign Contractor: State Bond #: Please Note: Sign contractors need to be City Contractor Licensed Address: City: State: Zip: Contact Person: Business Phone: Cell Phone: Email: Electrical Contractor Information Electrical Contractor: Contact Person: Sign Type Wall Free Standing Window Illumination, Electronic Message Center & Changeable Copy Temporary Sign Information Location of Sign: Sign Dimensions: Is Sign Illuminated? Yes No Illumination: Backlit Interior Lit Please Note: Electrical work requires a separate permit; Building permit may also be required. Sign Purpose: I hereby apply for a sign permit and acknowledge: the information above is complete and accurate; the work will be in conformance with the ordinances of the city of Gem Lake and Minnesota State Building Code; I understand this is not a permit but only an application for permit; work is not to start without permit; work will be in accordance with the Approved Sign Plan. A separate permit is required for electrical. I hereby certify that I have read and examined this application. Applicant Signature: Date: Please Note: This application must be accompanied by a scale drawing of the proposed sign and site plan for the property indicating whether the sign is electric or not and whether illumination of the sign will be required. In the case of sign illumination, each sign must specify type and rating of illumination. Office Use Only Permit No. Approved by: Date: Permit Price: Card Processing Fee: Permit Total: