HomeMy WebLinkAboutPermit Permanent Sign SN-11-75 - MOOSE LODGEr
Permit 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 #)
k1A1_q i,i Ai F v ems- I Aj G -
2) APPLICANT (Name, mailing address, phone and fax #)
3) SIGN LOCATION (include business name, address, & phone ft
--��c�T�a au �06SE t c7� sE �/f� /c�' id �l �yic-c /s�.�✓ .T�. ��.P�i��v
4) TAX PARCEL ID # (can be obtained at Assessor's Office
5) SIGN ERECTOR (Name, mailing address, phone and fax ft
7) DATE OF ERECTION
8) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter
1. �` � / C K % 0*1
le
SIZE (in sq. ft.):
l/
LA
2.
OVERALL HEIGHT: r 5
SIGNABLE WALL AREA in sq,,&):
OF ILLUM N:
TYP �ATI)
NOTE: A scaled rendering of 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: �T c� v Q� Date:
11) Signature of Land/Building Owner<)L Date:
Do not write below this line
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
Fee: II V A lication: ected rov
1
Code Officer Signature: Date: �� I
G%// i7�
���/C s
d A F- r q pe
S4 cKFp- o u A�b
-Ac
14:54� L31
y
u� Ar�R47'EkA)17-Y