HomeMy WebLinkAboutPermit Permanent Sign SN-11-15 - LEAPS & BOUNDS1
Permit Number SN-�
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) or OF RECORD (Name as shown on deed, mailing address, phone and fax #)
PO 90,t 6-i-7(18, PT 05"146( Rp' 3/0--&& 1
2) APPLICANT (Name, mailing address, phone and fax #) 6'CR VeSa(,tkh
3) SIGN LOCATION (include business name, address, & phone ft (k1,0
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4) TAX PARCEL ID # (can be obtained at Assessor's Office
5) SIGN ERECTORS (Name, mailing address, phone and fax #):
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7) DATE OF ERECTION 3127 h/
8) SIGN DATA — redgc-C e>,j -f�-c S,
WALL SIGNS (list size in sq. ft., illumination, d type
FREE-STANDING SIGN
such as panel or cut-out letter)pp
1.
S` SIZE (in sq. ft.):
S T
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
ATION:
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: �� z'�G Dater ,I
11) Signature of Land/Building Owner: Z""VV Date: -3 -. - P
Mk�jty
Do not write below this line
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Fee: S Ap lication: ected pproved
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Code Officer Signature: Date: �✓ ��
PRINT OFF SIGN AND FAX BACK TO 802-863-9772
1 Double sided 72.25"x58"
full color sign. Installed $675.00
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