HomeMy WebLinkAboutPermit Permanent Sign SN-11-63 - LEISURE WORLDPermit 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 #)
TUcS� Q. v�� I�L15 'uJ �-W
(�2� �? . tSSZ •nlnoy� _ (�602> �c� . Co2c�� -Fn.x
2) APPLICANT (Name, mailing address, phone and fax #) p�
05403
2 2 S52 or�2 2) 0 l&21ra 0 -c-ax
3) S'IGN LOCATION (include business name, address, & phone #): LekSu\(e \1,1o�v
4) TAX PARCEL ID # (can be obtained at Assessor's Office) 00 ZO — U 12415
5) SIGN ERECTOR (Name, mailing address, phone and fax #): (-�P- Wov 1d
7) DATE OF ERECTION
8) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as anel or cut-out letter
1•
2� X 15 ` I cks\d s e,
SIZE (in sq. ft.):
2 10
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.): 57.= 4� 51
TYPE OF ILLUMINATION:
GLL LullliGll"r, vi onkon limpwna sign muse oe suomittea illustrating the color of ttie sign and
noting the dimensions of each sign.
9) DATE OF DESIGN
10) Applicant Signature:
11) Signature of Land/Building Owner:
applicable):
Date: I 1 • C)9 I
Do not write below this line
Fee: placation: ted p r
r
Code Officer Signature: Date: �/
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