HomeMy WebLinkAboutPermit Permanent Sign SN-11-41 - LEAPS & BOUNDSPermit Number SN- ( q1
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City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #) Y02--3?Q` 6413
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3) SIGN LOCATION (include business name, address, & phone #): 3 S 01-/13
4) TAX PARCEL ID # (can be obtained at Assessor's Office) oh00
5) SIGN ERECTOR (Name, mailing address, phone and fax #): 95 -- 79$�
7) DATE OF ERECTION
8 SIGN DATA
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WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter
FREE-STANDING SIGN
1.
6'x 3' z"
SIZE (in sq. ft.): lSIF
2.
OVERALL HEIGHT:`
61
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
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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: Date: 2 0
11) Signature of Land/Building Owner: Date:
Fee: 5-5-
Code Officer Signature:
Do not write below this line
The j ect
IF
pproved
Date: ��
at WILLISTON ROAD
(1) 72" x 38" d/s Alumilite sign - $450.00
Plus install between two.,4x4 posts - $95.00
E-MAIL BACK APPROVAL AT OR
PRINT OFF SIGN AND FAX BACK TO 802-863-9772
SIGNATURE:
I have verified that spelling and content are correct. t am satisfied with
the document layout. I understand that my document will print EXACTLY
wssti„nc xv�,.ua,nr95 reous�wrxa recueevvm rrewar„zK� as ri appears. I assume all al for responsi riY typographical errors.
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AERIAL PHOTOGRAPHS
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