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HomeMy WebLinkAboutPermit Permanent Sign SN-17-40 - ALLSTATEPermit Number SN--1-- City of South Burlington, Vermont Application for Permanent Sign Permit 1) OWNER OF RECORD (Name as shown on deed, ailing address, phone and fax #) i lil���l LrJJ C i^}' i �! Z `� y n.JCv !'� C•i �T 2) APPLICANT (Name, mailing address, phone and fax #) Twin State Signs Inc. 14 Gauthier Dr Essex Jct., VT 05452 802-872-8949 fax 802-878-0200 3) SIGN LOCATION (include business name, address, & phone ft eft c, y T 4) TAX PARCEL ID # (can be obtained at Assessor's Office 5) SIGN ERECTOR (Name, mailing address, phone and fax ft Twin State Signs, 14 Gauthier Drive Essex Jct., VT 05452 R02-872-8949 fax 80 -878-0200 7) DATE OF ERECTION X- w ; 1, '} 8) SIGN DATA rACC e(AA-eyF' WALL SIGNS (list size in sq. ft., ill . tion, & type FREE-STANDING SIGN such as panel or cut-out letter) 1. SIZE (in sq. ft.): -2s �CI-% 2. OVERALL HEIGHT: f SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: 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: 1140ilgUe Uilardt Date: - - 11) Signature of Land/Building Owner: ec,,e r HSt �,,Date: Do not write below this line 0000009000000000 Fee: Application: Rejected pprov Code Officer Signature: Date: -7/ P H I L A D E L P H I A S I G Philadelphia Sign Company - 50 Porter Rd - Littleton. MA 01460-1414 Re: Smell) 1 T2F? Id'aher Hattsermann 4001 ffWisron Rd S Burlington, VT 05403 AUTHORIZATION AND CONSENT FORM By my signature below, I hercbv represent that I am the owner of the property indicated above or otherwise duly authorized by the Lease to grant authorization for Philadelphia Sign Company'and/or their sub -contractor to applN for permits and install new signage at the above referenced location. I acknowledge that the signs (including cabinets) that are installed will remain the property of Allstate Insurance Company and may be removed upon the termination of the agency agreement or lease or for any other reason with 10 days notice to me. Please check one: Ck/Philadelphla Sign and/or its sub -contractors is authorized to remote the existing sign and/or sign cabinet and dispose of it. 1 agree to waive all right, title and interest in such sign and/or sign cabinet. Philadelphia Sign and/or its sub -contractors is authorized to remove the existing sign and/or sign cabinet and leave on premises in a location designated by me. LANDLORD APPROVAL ::Vln\ / Signature _ _ _ Print Nuutc1Gt1�L](h.__._v Title) —a 1�/vr�---------- ---- ematl Address-�� b �L,Aw _ PhoneL '- � �G 11(�1b Return Form to: Philadelphia Sign Compan- 50 Porter Rd Littleton, t'1A 01460-1414 or FAX to: (978) 486-0138 attn: Mary'Ellen McCarthy or email to: memccarthy(aphiladelphiasign.com GKMr S M TYPE S M t>ESC1110111taM ACTT M E01 ALST.CUSTJ*C S Q h x 5 01w Acrylic Reface of Existing Doude Faced Ilhwnirtiated Montxnent Sign Reftm Sign PROPOSED SIGNAGE PHOTO T, :0.ice .. 7-7 - r _ I �T PHILADELPHIASIGN ANT: ALLSTATE LOCATION: YTRF2 Wafteir Hauserman 707 West Spring Garden Street 4001 VYWOm Rd Palmyra, NJ 0806.5-1798 Sough BmkKjton. VT I EXISTING SIGNAGE PHOTO Existing Sign Dimensions: so•hx5'O'w �.1 + { ✓I *NOTE: Your approval of the Brandbook indicates your acceptance Y that the signage, provided to you and owned by Allstate, will be manufactured and installed as shown, pending landlord and/or municipality approval. Once accepted, signage may not be declined at time of installation for any reason other than a manufacturing defect. Any Allstate -branded items that we install are the property of Allstate . - NE DATE: REVISION: THIS a - OR — NE 0&11.17 JHH Revised E01 CREAK E9Y PNN,VJElP111A SHEET: S GN R S SUBW TED FOR Poll WR PERSONA USE IN CONJUNCTION 4 H A PROJECT BEING PLANNED FOR YOU BY DMIG BY: PRNADEL —. IT Is NOT TO DS BE SHOYM TO ANYONE WTSRIE VWR ORGA..— NOR IS a .0 .. I V 113 f ♦t ` 40 i• s � �r