HomeMy WebLinkAboutPermit Permanent Sign SN-15-42 - LACEY'SPermit 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) APPLICANT (Name, mailing address, phone and fax #)
3) SIGN LOCATION (include business name, address, & phone #):
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
13,
7) DATE OF ERECTION
8) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter)
FREE-STANDING SIGN
1.
SIZE (in sq. ft.): C
2.
OVERALL HEIGHT: 6
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
el'
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 VAL (if a le):
10) Applicant Signature: Date: > G
11) Signature of LandBuilding Owner: d Date:
Do not write below this line
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Fee: Ap lication: Reject d ❑ Approved
Code Officer Signature: Date: (� ✓r
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C491LACEY'S
The CarpetMaster
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466 Shunpike Rd., Williston, VT 05495