HomeMy WebLinkAboutPermit Permanent Sign SN-14-59 - DM INTERIORSPermit Number SN- 1 -
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWOF RECORD (Name as shown on deed, mailing address, phone and fax #)
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2) APP ICANT (N me, mail address, phone and fax #) � 3Oki
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3) SIGN LOCATION (me ude business name, address, & phone
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
7) DATE OF ERECTION
81 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter)
FREE-STANDING SIGN
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SIZE (in q. ):
2•
OVE L IGHT:
SIGNABLE WALL AREA (in sq. ft.):
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PivYvbcu W611 lllusl oc suounuEeci musuating the color ofthe sign and
noting the dimensions of each sign.
9) DATE OF DESIGN REVIEW APPROVAL (if applicable):
10) Applicant Signature:_ Date: 1�=�
11) Signature of Land/Building Owner: Date: G, [
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••eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeaeeeeeeeeeesee•
Do not write below this line
••eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee•
Fee: lication: R ' ed pprov
Code Officer Signature: Date: 1 V7/
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