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HomeMy WebLinkAboutPermit Permanent Sign SN-17-24 - 110 KIMBALLI Permit Number SN- ( 1--; City of South Burlington, Vermont _ Application for Permanent Sign Permit 7"aV. 1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #) 2) APPLICANT (Name, mailing address, phone and fax #) ? /2 2. 3 3) SIGN LOCATION (include business name, address, & phone #):Z(p2• /22-5 /%D % /X•Ci��GL �� S�. 4) TAX PARCEL ID # (can be obtained at Assessor's Office S) SIGN ERECTOR (Name, mailing address, phone and fax 7) DATE OF ERECTION 12-1 O Z 8) SIGN DATA WALL SIGNS (list size in sq. ft., illumination, & type such as panel or cut-out letter) FREE-STANDING SIGN l . SIZE (in sq. ft.): S 2 , 2. OVERALL IIF,IGHT: S i i SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: NUM : 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 REVII APPROVA if applica ): —1 Z. ZV , D �L- 10) Applicant Signature: Date: l) . 1 11) Signature of Land/Buildi her: 0,4Sij 72�5jc7 Date: Do not write below this line Fee: 6 Application: Rejected ❑ Approved Z/ Code Officer Signature: Date: �� /% L�'�T11 'OF �1���11u aG Qu �l�'1��A�TViT 575 DORSET STREET SOUTH BUPWL I GT01',T, ITE13MGNT 05403 (802) 846-4106 FAX (802) 846-4101 P emit Number SN- Application for Permanent Sig Pe1< Iit 1) G7-✓} 1ER O EI CO (-Nanie as shown can deed, maYYing address, phone and fax # 2) APPLTCAt 7 (;i,,Tame., mailing address, phone and fax #) u/" �S�cTZ /Za I-tM�Ac Llrc —F z- (zZ q(r,� . y42,0 -{-x 3) SIGN LOCATION (include business name, address, & phone #): //0 J�(M fi t, A-\,� ,,?. 4) TAX PARCEL ID # (carp be obtained at Assessor's Office) 51 STGN ERRECTOR (Name, n}ailing address, phone and fax #):�- 6) DATE OF ERE CTION� 7) STGN DATA WALL SIGNS (list size in sq. f., illumination, & type FREE-STAIND&TG SIGN such as panel or cut -cut letter) I 1. S= (in sq. ft. ): 2. OVER AT L HEIGHT: S' SiG1,1AELE WALL Aft; ,A (in sq. ft.): TYPE OF I[,LUTvffNATION: //-3 LDS U®ll . NOTE: A. scaled rendering of each proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. 3) DATE OF DESTGNI REVIEW APPROV - (i licabie): :� �„/ v C� 9) Applicant Signature: 17, Date: //A, 4-1 �� Il 10) Signature of Land/Euildtrag Owner: Date: ✓s 3ma0nawoo0am00000o®aaoama000aaooeFew00000aowa000pa0 ©0�ariooaeoowv0000aa000 D0 not w ite ow this line �ooev06006e0eoe eaoae 000a �ePewasaaaoaGaaeaAa�eaaaeace,�eaezaaovaouwa®aoa®oaomooaeaaaea,matoeoom4a.o®enooea®®o®esaboeeao®a®aoamoaooara Fee: Application: iected. EApproved Code Officer Sioiature: � ,�' ,�% J � „�f � Date: '��� � w t!. Fab ti' /•e , '� J`'; :. ,r m.<