HomeMy WebLinkAboutPermit Permanent Sign SN-15-04 - CHITTENDEN CLINICI
Permit Number
City of South Burlington, Vermont
Application for Perluxiont Sign. Permit
1) QWNE. OF RECORD as show n�tl.ed, r�}ailin address, phone and fax #) /
-44
J
2) APPLICANT (Name, mailing address, phone and fax #)^
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0. l�oZ. Lt9-2A.f.1g17_ r, g 0 Z t-d'o i• (�qol
t3\)Uj-lq'r�Ith,
VT-o�t01
3) SIGN LOCATION (include business name, ac:ldress, & Dlione #): C ft IT Z7I~ NQ r—M C- --J NJ C:-
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4) TAX PARCEL ID # (can be obtained at Assessor's Office)__ _qt O O O 715
5) SIGN ERECTOR (Namc, mailing address, pli.one and fax #): _
C1to<,, r 1z N�!1..._ t i 'L� 1nt I t- �a i ►�1 �p -615
7) DATE OF FRECTION_____._4
8) SIGN DATA _
WALL. SIG'vS {list size in sq. ft., iilurnination, & type
� such as anel or cut-out letter
1. rvt� i5"wf- 60"10&q
2.
SIGNABLE WALL WA (in sq. ft.):
NOT - scaled rendering of each proposed s
noting the dunensions of csaoh sign.
TREE -STANDING SIGN
SIZE (in sq. ft.):
OVERALL HEIGHT: �^
TYPE OF ILLUMINATION:
must be submitted illustrating the color of the sign and
9) DATE OF DESIGN REVIEW APPROVAL (if applicable):
20 •!
10) Applicant Signature: '` Date: 1
11) Signature of Land/Building Owner:.,, ""ate:
**see* tots t tsssssits ttttstsststts ttt teeth ttt •ttttttttttssttiiststssstsstsss
Do not write below this line
tt sttsttttstttssssssNSOs 00s060*0 tot 0000 tslNsstsstssstsst tt tttstsitist sss
A lication: Re"ecte ❑ Approved
/� Code Officer Signature: Date: �
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HOWARD
CENTER
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