HomeMy WebLinkAboutPermit Permanent Sign SN-16-21 - VERMONT TEETH WHITENINGPermit Number SN-
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
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2) A PLICANT ame, mailing addressY.P
hone and fax #)
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3) SIGN LOCATION (include business name, address, & phone #):
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) \ %kO 0A0401
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
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.
S (in sq. ft.):
16VQ er c ^
2.
OVERALL HEIGHT:
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SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
� sing
`i0 SC
Sint 04) - 1Mw.
N U Lb: : A scaled rendering of each proposed sign must be submitted illustrating the colotJM the sign and
noting the dimensions of each sign. rr d g«Lk I y-*4 w;+k u 1A; tle L. t Ne 5
9) DATE OF DESIGN REVIEW APPROVAL (if applicable):
10) Applicant Signature: wo Date: %1 12*1�
11) Signature of Land/Building Owner: Date:
•.•••••...•...••.•••.•••..•...•..............•...•••.•........•...•.•.........
Do not write below this line
Fee: Application: Rej ected ❑ Approved
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Code Officer Signature: Date: /'el