HomeMy WebLinkAboutPermit Permanent Sign SN-14-20 - POULINPermit Number SN- -
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNED. OF RECORD (Name as shown on deed, mailing address, phone and fax #)
2) APPLICANT (Name, mailing address, phone) and f #) Pot,.,�►'vi,-ihcxv ,o
�D �i.� ji /_ P r %Cis h!' I /�. v �, e- !? /'j
C�a�IO
3) SIGN LOCATION (include business name, address, & phone #):
�l 9S S�l 117/�.r/'r " sn pc,.:Y- I nA i
4) TAX PARCEL ID # (can be obtained at Assessor's Office
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
c, t-u&o Fr42 -9& GZ3
7) DATE OF E12ECTION jtjL y 1 d Z
8) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-ST:/-ihDI G SIGN
such as panel or cut-out letter
1.
SIZE (in sq. ft.):
2.
OVERALL FIGHT:
A
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
Lr
NOTE: A scaled rendering of each proposed sign must be submitted illustrating the cclor of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN REVIEW PROVAL (if applicable):
10) Applicant Signature: c Date:
11) Signature of Land/Building Owner: Date:
Do not write below this line
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Fee: A lic on: Rejected Approved
r
l Code Officer Signature: LI Date:
/� /
96 in
96"W x 12"D two-sided cabinet
Two embossed pan faces
Single pole mount for 6" OD pole
36"W x 120"H x 10"D pole cover
Pole cover and cabinet painted silver
M.B.
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