HomeMy WebLinkAboutPermit Permanent Sign SN-12-10 - GOVERNOR'S INSTITUTElvq .S
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575 IDOFLET STREET
'FEJi tea. 1 V 1 T—P 0,5403
c` 02) u45-4106
E_27 (SC2) 346-4101
Permit Number SNT I� - 1"
AD-ph,,2z1c) --n T(-)r Pem anent Sign Putt
R CCR3 (Name as shown on deed, ,nailing address, phone and r
2) APPLICANNT Q-Tame, mailing address, phone and fax #)
0 099 y 1 i 5 1-M 4 0' C L( , S c
{ITT-: tC i r e v. Tc-y in J`1 k V k -c (i 7 Y- G -7 7
3) SIGN LOCATION (include busi�►ess nine, address, � hone #):
.�� u r 1, YN,.f n,
4) TAX P_ RI CTL ID # (can be obtained at Assessor's Office) ( F 1 c o `h, �l "�
5) STCN ERECTOR (Name, mailing address. phone and fax #):
b) DATE OF ERECTION
7) STGN DATA
`WALL SIGNS (list size in sq. ft., illumination, & type
FR-EE-STANDING SIGN
such as panel or cut-out letter)
5� w� n �' j-t i to ct e
SIDE (in sq. I):
11.
i ree� � s'avi;i si '�•� bt�.� krt— �2►� c�tt6<(
2 ` `
I OVERALL =GET:
SIGNABLE WALL AREA (in sq. f.):
TYPE OF ILLUMINATION:
I
NU i h: A scaled rendering of ?ach proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN REVMW APPROVAL (if applicabie):
9) Annlicant Signature: '��;. Date:
10) Signature -,fLand/5uiiding Ovvner: U� brk l Date: �Iq��
i not ,irite below this lime
/ aesna
�liiatis;
.__;dc 0fricer mature:
4049 Williston Road, Suite 4
South Burlington, Vermont 05403
Address Service Requested
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