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<br />~~ <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT. PHONE: 651-490-2238. FAX: 651-490-2931 <br />2660 CIVIC CENTER DR. . ROSEVILLE, MN 55113 <br />SIGN PERMIT APPLICATION <br /> <br />PERMIT NUMBER: <br /> <br />WORK PROPOSED: <br /> <br />""'" <br />L ,,~ew Signage <br /> <br />o Face Replacement <br /> <br />D Temporary (Dates: <br /> <br /> <br />H/"II I, L- <br />v CJ..- -r--+-c_Cr ) c <br /> <br /> <br />() <br /> <br />SIGN DETAILS: <br /> <br />I <br /> <br />SIZE OF SIGN: <br /> <br />. <br /> <br />Sign Location&-e..~ ~~;b/ {.. t4 A-" <br />7. ~'- I" "r<:." Ii c t <br />Setbacks Frontx XT\ (;::::>I+S: t/.. ' <br /> <br />Side: <br /> <br /> <br />Acknowledgement and Signature: <br />The undersigned hereby makes application to the City of Roseville to perform the work as herein described. The undersigned further states, under penalty of <br />law, that the work will be performed in accordance ,'lith the Minnesota State Building Code. this application, and any approved plans and/or specifications. <br /> <br />Print Name'ThOM6-!;' N e.-+l" <br />o Contractor 0 Owner )( Other: <br /> <br />Fees: <br />Permit <br />State Surcharge <br /> <br />Approvals: <br /> <br />Plan Reviewer <br /> <br />$ <br />$ <br /> <br />Planning <br /> <br />Contractor's License $ <br />Other: $ <br /> <br />Total Fees: $ <br />Receipt #: <br />Receipt Date: <br /> <br />Engineering <br />