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Permit Permanent Sign SN-12-41 - 4050 WILLISTON RD.
^TI' c� l 1 i1,, �' 'v ��7TH F U 1 ll' 'C� �i TPLAPTT\T�,TG til 1-70- TMTC- 575 DORSET STREET 30UrH BURLLNGTON, VErRMONT 05403 (802) 846-4106 RA27 (802) 346-4101 Permit r Number - S T -�� Application for Perm anent Sign Permit 1) O vI NER OF RECORD (Name as shown on deed, mailing address, phone and Fax #) 2) APPLICANT (Name, mailing address, prone and fax #) 3) SIGN LOCATION (include business name, address, & phone #): l eJl O -Ze z 'i> 4) TAX PARCEL ID # (can be obtained at Assessor's Office) �—Cj c O-s� 5) SIGN ERECTOR (Name, mailing address_ niione anti fax #1• 6) DATE OF ERECTION 7) SIGN DATA TFC�_e_ < WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING SIGN such aspanel- or cut-out letter) 1. SIZE (in sq. ft.): 2. OVERALL HEIGHT:v t SIGNABLE WALL AREA (in sq. ft.): TYPE OF IL�U-\/�-IATION: �,r��-NOTE a .. scal ed rendering of each proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. 8) DATE OF DESIGN REVIEW APPROVAL (if applicable): 9) Applicant Signature: ate: 10) Signature of Land/Building Owne Date: c 3OebdvdgOCeOevOe4m0©06mOSgvOOm0000Vev®0v69mq eu.ioo©m®vUJgQeoe6tlOmnegogHooY�ooeomSD 8o0o6eoov8v o6eoo em Do not write below this line aueeaee•+e000ee9ag �o�e eeae000aoaaaoaooees0000aoeavasesseoe0000moeeeoeveea000eovee aoeos000eaomaeaaa Fee: 5 A 'c tion: Cl c Appraved Cade Officer Signature: Date: 0 ►❑ I E 1 d i VA Vermoni Bed A00 1�j O Designs are copywrite © 2012 by Design Signs, Inc. and may not be used without permission. i 802-872-9906 © 2012 designsignsvt.com Precourt Development Revised sign for 4050 Williston Road September 21, 2012