HomeMy WebLinkAboutPermit Permanent Sign SN-05-83 - MOE'SPermit Number SN--- �33
City of South Burlington, Vermont
Application for Permanent Sign Permit
OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #)
3 SIGN LOCATION (incluqa business name, address, & phone ft l f o- � ; r ; Q_
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) Q — D yo
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7) DATE OF ERECTION
8) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
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1.
SIZE (in sq. ft.):
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
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NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN RE. W APPROVAL (if applicable): C
10) Applicant Signature Date: 1 J
11) Signature of Landau li ding Owne`%�1;���� Date: 1Z
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Do not write below this line
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Fee: lication: Rejected cp�ro�v
Code Officer Signature: Date: /
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southwest
grill`
Design Signs, Inc.
644 Blair Park Road
P.G. Box 1048
Williston, VT 05495