HomeMy WebLinkAboutPermit Permanent Sign SN-12-39 - LOWESPermit Number SN- -
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
VJ 1",)//U(,ar MY,- C) /L
2) APPLICANT (Name, mailing address, phone and fax #)
3) SIGN LOCATION (include business name, address, &
to.JF112-1 ) ► 1 _1 1'21J`CLL (
4) TAX PARCEL ID # (can be obtained at Assessor's Office
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
i !% t� % IaY r �. 1c l ,U i,J! rJdleili _ 12-1
7) DATE OF F,RECTION ; 1 } 2(] J Z_
81 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cu gut letter
1.
SIZE (in sq. ft.): _
.71
2.
OVfRALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
ivvi b: A scaled rendering or 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 ate: l Z--
r
I t write on
this line
Fee: V lication: Re' c e A prow
Code Officer Signature: Date:
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