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Permit Permanent Sign SN-11-58 - PHOENIX PHYSICAL THERAPY
t mber N- 1 Perms Nu S City of South Burlington, Vermont Application for Permanent Sign Permit 1) OWNER OF RECORD (Name '�aJJ�� shown on deed, mailing address, phone and fax #) � hJ C'air s �O vell" "4- 3o rnnat,p S& 2ef -e o i V`i' 054 o t e.3 � � is'63. 13t3 2) APPLICANT (Name, mailing address, phone and fax 3) SIGN LOCATION (include business name, address, & phone #): t-t "TS Ali f l i al -a n 12o ct-4 6au_41f�% VT- o S q o 3 4) TAX PARCEL ID # (can be obtained at Assessor's Office) I g ©. O 1 ? -7 5 5) SIGN ERECTOR (Name, mailing address,hone and fax #): P. o . � X ES "7 D . �55 e �c .1 n r.. V o ;4-F3 r2 Pl+: .S-7 z, 4g t)"r„ t r-" 8-12. 99 1r) 7) DATE OF ERECTION r rvtfn b cvY 2- o 1 Rl 4T('TN T)ATA WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING SIGN such as panel or cut-out letter 1. phop-At)c P17P[C -1 TT"Ll -- SIZE (in sq. ft.): 2. OVERALL HEIGHT: SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: a 4 o s r-- 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: �&, 11. Date: ° 7.11 11) Signature of Land/Building Owner: 1&, Date: / 0, 2-7 < <( Do not write below this line Fee: Ap cat' n: Lejectlw 6pptj Code Officer Signature: Date: w �� f _ 48 " Aluminum directory, materials and colors to match interior lobby directory. Designs are copyright Q 2011 by Design Signs, Inc. and may not be used without permission. 8Q2-$72-9905 2011 designsignsvt.com 00, ICV 1775 Williston Road New directory on back wall October 4, 2011 i 00 M 1/