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HomeMy WebLinkAboutPermit Permanent Sign SN-12-01 - DRS SHUMAN, LEVI, ----Permit Number SN-J�_- v City of South Burlington, Vermont Application for Permanent Sign Permit 1) OWNER OF RECORD (Name as sown on deed, mailing address, phone and fax #) InJeS S Car a ton ver 3U G1ir► �5cic CFO 1earliKafa a %flr CS-1 O I 2 S 11 F: g63•�3i3 2) APPLICANT (Name, mailing address, phone and fax #) D 3) SIGN LOCATION (include business name, address, & phone ft t`7`t5 Int;ll,t(-an � Sot,�th B rl�fDn VT on403 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 181 O. O 1 T7 S 5) SIGN ERECTOR (Name, mailing address, phone and fax #): _lam :l n CSC nS P. O . 90x. _95 1 Oi £.sse4n 0 ek. , ✓ i 0 -4 5 1 7) DATE OF F,RECTION 8) SIGN DATA WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING SIGN such as panel or cut-out letter 1. SIZE (in sq. ft.): 10"X 24" 2. OVERALL HEIGHT: SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: t�raun 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 REVIE APPROVAL (if applicable): 10) Applicant Signature: Date: 1. U • (1- 11) Signature of Land/Building Owner: 06UL !d`� Date: l • I (. ( z Do not write below this line Fee: Ap is tion: '_e) ted (Approve Code Officer Signature: Date: �� f 1775 Vermont Gynecology pHo� PHYSICAL THERAPY, PLC Zydus Noveltech Inc. Nancy Carlson Fisher, MD Lumina Drs. Shuman, Levi,___ AMIl Halliday & Kolesar Designs are copywrite Q 2012 by Design Signs, Inc. and may not be used without permission. 802-872-9906 © 2012 designsignsvt.com ICV 1775 Williston Road Add AIP to street directory January 3, 2012