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HomeMy WebLinkAboutPermit Permanent Sign SN-11-59 - VERMONT GYNECOLOGYPermit Number SN- City of South Burlington, Vermont Application for Permanent Sign Permit 1) OWNER OF RECORQjn_D (Nameas shown o deed, mailing address, phone and fax #) 30 maZI e U k-11 n 03$ o l : $% 3 • �311 F: no 2. • 313 2) APPLICANT (Name, mailing address, phone and fax #)_ 3) SIGN LOCAT ON (include bgsmess name, address & phone #)- 4) TAX PARCEL ID # (can be obtained at Assessor's Office) \' I 9—to , o r 77! 5) SIGN ERECTOR (Name, mailing address, phone and fax #): ve-S po 3 Zjc -7 o (= bse�sc 0C, '_. 1 i Q� S 2- Ott all 2. 94 om f F'T;z- 4a lU 7) DATE OF ERECTION 81 SIGN DATA cNPmnL�e� 2 D WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING SIGN such as panel or -cut-out letter 1.( 2 •O 6 U SIZE (in sq. ft.): 2. OVERALL HEIGHT: SIGNABLE WALL AREA (in sq. ft.): (00 5F TYPE OF ILLUMINATION: 1V U 1 b: A scaled rendenng of each proposed sign must be subnutted illustrating the color of the sign and noting the dimensions of each sign. 9) DATE OF DESIGN REVIEW APPROVAL (if applicable): 10) Applicant Signature: a�. 4e-� Date: l 0 11) Signature of Land/Building Owner: &L, VY� •1'I 2 Date: .............................................................................. Do not write below this line Fee: Application: Rej ct Lpprove_d"_) Code Officer Signature: Date: A Vermont Gynecology '1- P! oCLE !X Md.. w 48 " Aluminum directory, materials and colors to match interior lobby directory. Designs are copyright © 2011 by Design Signs, Inc. and may not be used without permission. 802-872-9906 © 20"1 . designsignsvt.com ICV 1775 Williston Road New directory on =k wall October 4, 2011 Ak 00 Co