HomeMy WebLinkAboutPermit Permanent Sign SN-12-18 - SIMPLEROUTEPermit Number SN- 6
City of South Burlington, Vermont
Application for Permanent Sign Permit
1 OWNER OF RECORDMe as show on deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone an/d� fax #) I Jfe ff
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3) I I� LOCATION (}nclude business name, address, & phone #): S6-
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) D
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7) DATE OF ERECTION `^- 6 115j?o/Z
81 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
I.
SIZE (in sq. ft.): n O
2.
OVERALL HEII H T:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF L ATION:
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NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign ano
noting the dimensions of each sign.
9) DATE OF DESIGN REVIEW APPROVAL (if applicable):
10) Applicant Signature:' V Date: 312 T 12017—
11) Signature of Land/Building Own Date: ,7
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Do not write below this line
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Fee: ication: c CPPv
Code Officer Signature: Date:
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ONCE YOU HAVE SIGNED AND DATED THIS FORM, THE COPY YOU HAVE PROOF READ IS CONSIDERED FINISHED AND READY A% SIGNS
FOR PRODUCTION. ONCE THIS FORM IS RETURNED TO US SIGNED, WE ARE RELIEVED OF ALL RESPONSIBILITY FOR ANY
ERRORS THAT MAY BE DISCOVERED AT ANY TIME IN THE FUTURE. c7i 14 Gauthier N"
ve
Proof read and approved----------------------------------------------------------------- Date ---------------------
Esser Junctiomn, VT 054 5 2
■ PAPER DRAWING IS NOT A COLOR PROOF LA: 802-872-8949
Note that the colors used in this paper print represent the colors to be used in the project but do not represent those colors exactly and fax 802-878-0200
are not intended to be used to color proof the project.
1 have read and understand that colors in drawing are not exact e—mail t'Ainsign@together.net
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