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HomeMy WebLinkAboutPermit Permanent Sign SN-17-52 - GGT TIBET INNPermit Number SN- - �`A City of South Burlington, Vermont Application for Permanent Sign Pe=h 1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #) k-A(-sn m 9 Ci e,^ i S02- nS- T-1 D iSs/'b 9P61-6Ui2ArE kl> Cuu7N 4-L4g4'1/,j fl/,j, V7-0�,03 2) APPLICANT (Name mailing address, phone and fax #) SA3 Z - q C 3 -1 H u - - - , -I ,;?. k os`4.7D3 3) SIGN LOCATION (include business name, address, & phone #): a G % 7/,' E7 //VA/ -Q U 7l 1 d U rZG / n1 (- 7(j A) ` D s72 02 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 5) SIGN ERECTOR (Name, mailing address, phone and fax #):�- w(LI-t$76r-1 . (r7- © ti4c" 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) 1. SIZE (in sq. ft.): 2. OVERALL HEIGHT: 1 ` -7 " SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: iM.6� L{Ck 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 REVIEW APPROVAL (if applicable): 10) Applicant Signature: 11) Signature of Land/Building Owner: .••.•..•••.•.•.•••.•.••...••.......•••..•...• Do not write Date: Date: Fee: Application: Rejected ❑ Approved Code Officer Signature: Date: C% ,;,�•,� �'rvy y, tin � •�'��:► .F,� �� ' .�;;.. rods �1 -, a4 r ,v ._�, � ., rid; ' x • •� . .'M. + t x A4 Az