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HomeMy WebLinkAboutPermit Permanent Sign SN-11-53 - DRS SHUMAN, LEVI ----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 #) I r%,,/PA4-&y s Ga r r vTv n k s c, r.-P 4 — a-ln �f"t ems' U 0! t' rl i n tOrN VT D 540 I Pt T(v 3. 2 3 (I F: $6 3 . '.1 3 13 2) APPLICANT (Name, mailing address, phone and fax 3) SIGN LOCATION (include business name, address, & phone #): 4) TAX PARCEL ID # (can be obtained at Assessor's Office) / ? 1 O • O 1-7 7 5 S) SIGN ERECTOR (Name, mailing address, phone and fax #): DeS(cIn O. RS-70 I S Je f. ✓7 p 6-gs j P: Fs7�L-• 9Rv6 / F: Ss�-a i 0 7) DATE OF ERECTION (Qcf-D/0 e-A 20 ( I 8) SIGN DATA WALL SIGNS (list size in sq. 8., illumination, & type FREE-STANDING SIGN such as panel or cut-out letter I SIZE (in sq. ft.)::� , a ay �( 2• OVERALL HEIGHT:. l SIGNABLE WALL AREA (in sq. ft.): _T TYPE OF ILLUMINATIO- N: --A C9 r 0-vt_ (, - • -- _ • - • ���•�� =�=�u�=.==5 vi ca�u piupvscu slga 1ausL oe suomineQ lllusuating the color of the sign and noting the dimensions of each sign. 9) DATE OF DESIGN REVIEW APPROVAL (if applicable): 10) Applicant Signature: Date: e 11) Signature of Land/Building Own Do not write below this line M1 Fee: 3� I� Ap lication: ect pprov I Code Officer Signature: Date: / G / co 1775 1 C Vermont Gynecology PHOENIxi PHYSICAL THERAPY, PLC Zydus Noveltech Inc. Nancy Carlson Fisher, MD co Lumina Drs. Shuman, Levi, Halliday & Kolesar i �, Designs are copyright © 2011 by Design Signs, Inc. and may not be used without permission. i M C O N A E O 802-872-9906 Q 2011 designsignsvt.com ICV 1775 Williston Road Option A and B additions to stree+-,'irectory October 2, 2011