HomeMy WebLinkAboutPermit Permanent Sign SN-11-33 - BENNIESPermit 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 #)
2) APPLICANT (Name mailing address, phone and fax #)
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3) SIGN LOCATION (include business name, address, & phone #):
4) TAX PARCEL ID # (can be obtained at Assessor's Office) ac`lo- Zr/ooee(-+
5) SIGN ERECTOR
mailing address, phone and fax #):
7) DATE OF ERECTION 6 ( '�9 I It
8 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter
1.
SIZE (in sq. ft.): �}
5q_ fit'
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION: it
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: LADate: Oxn ((1
11) Signature of Land/Building Owner: A Date:
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Do not write below this line
Fee: Aplication: M7" prove
Code Officer Signature:
Date:
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