HomeMy WebLinkAboutPermit Permanent Sign SN-12-61 - GREEN MT. CAMERAPermit Number SN-A-.
City of South Burlington, Vermont
Application for -Permanent Sign Permit
1) OWNER OF RECORD (Name as sh wn on deed, mailing address, phone and fax ##)
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2)APPLICANT (Nanie, mailing address, phone and fax #)
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3) SIGN LOCATION (include business name, address, & phone #):'v� L,lit U INN
4) TAX PARCEL ID # (can be obtained at Assessor's Office) Q " ctS
5) SIGN ERECTOR (Name, mailing address, phone and fax #).
7) DATE OF ERECTION%1%�r
Rl SiGN DATA
WAIL', CNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as innel or cut-out letter)_ —!
ft.):
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SIZE (in sq.
2.
OVERALL ftEI6RT:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
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NOTE: A scaled rendering of each proposed sign must ne suo ntaea uiusuaung i uu Uviv. W.
noting the dimensions of each sign.
9) DATI? OF DESIGN REVIE ROV ;(ifapplicable,�.
10) Applicant Signature: Date:
11) Signature of Land/Building Owner: ate: I ,Z
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Fee: 2--M&
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Code Officer Signature:Date:
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South Burlington, Vermont
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Williston Road (US Route 2)
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