HomeMy WebLinkAboutPermit Permanent Sign SN-11-69 - FLOOR COVERINGSDO
Er)ER4�TFAIE, NT GE PIAIITNING &' 71,0NE,TG
575 DORSET STREET
OL'1H BURLLNGTON, '17ERA.IO0 ,T 05403
(802) 846-4106
FP1a (802) 846-4101
Permit Number SN-
Application for Permanent Sign Permit
OF RECORD (Naine as shown on deed, mailing address, phone and fax #)
2) APPLTCANT (T,Tarne, mailing address, phone and fax
3) SIGN LOCATION (include business name, address, & phone #): ZE ,z �_�,�\,,kq�5
'I N&�& — -5 — � . _ _ \ I I i'/ I .1, . . - _ 1 _ -ram _ _ —
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (NIame, mailing address, phone and fax #):
b) DATE OF ERECTION 4 ,=,o rpcn-.__� S
7) STGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter)
FREE-STANDING SIGN
1. x '� \ArA
O �a
SIZE (in sq. ft.):
2.
OVERALL HEIGHT:
SIGNABLE WAIL AREA (in sq. ft.):
TYPE OF ILLUM NATION:
ruu t u: a scaled 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:
10) Signature of Land/Building Owne - `
aeaoeaa000000a�soasoa0000ae000eooe000ewoaoac oaaa+0000e000eopa
Do not write blow this Kw
�ee�e�eoeoaaeaaepew�� oaeaoaHaoaaaoe�ea�e
Fee: 5 -lv Ap n:
Code Officer Signature:
Date:
84 in
FLOOR COVERINGS
802-655-9663