HomeMy WebLinkAboutPermit Permanent Sign SN-08-26 - CENTURY 21Permit -Number SN- Ob -
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OA;ZVEROF RECORD (Nan e as shown on deed, mailing address, phone and fax #)
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APPLICA T (Name, mailing address, phone and fax #) 2m AW C_e
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3) SIGN LOCATION (include bu 'ness name, address, & phone #): 01V e K f S' vl-i .,,vi
4) TAX PARCEL ID # (can be obtained at Assessor's Office)'-
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
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7) DATE OF ERECTION
8) SIGN DATA
WALL SIGN�(iis.ttsize in sq. ft., illumination, &type FREE-STANDING SIGNsuch as anel or etter)
1' SIZE (in sq. ft.):
'
2' OV L HEIGHT: 1
SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATI :
NOTE: A scaled rendering of each proposed sign must be submitted illustrating the co or of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN RE IEW APPROVAL (if licable):
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10) Applicant Signature: Date: % , Z1Gv
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11) Signature of LandBuilding O ner• Date: LAI4 / 3" z00r
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Do not write below this line
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Fee: lication: ject d Epov
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Code Officer Signature: (� Date: /� ��
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302-000-0000
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