HomeMy WebLinkAboutPermit Permanent Sign SN-13-13 - CHAMPLAIN VALLEY AUTOPermit Number SN-�
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, Dhone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #Y6D2 `� 14 14
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3) SIGN LOCATION (include business name, address, & phone ft
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
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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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SIZE (in sq. ft.):
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OVERALL HEIGHT:
SIGNABLE WALLfib (in sq. ft.):
TYPE OF ILLUMINATION:
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 APPROVAL (if applicable):
10) Applicant Signature: Date:
11) Signature of Land/Building Owner: ���(� Date:o U?&
Do not write below this line
Fee: Op Ap 1• ation: Rejected
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Code Officer Signature: Date:
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