HomeMy WebLinkAboutPermit Permanent Sign SN-10-62 - NATIONAL GUARD08/06/2010 14:13 0023383401 VTARNG FMO OFFICE PAGE 03/04
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City of South Burhagtonl 'Vermont
Application for Pormaneat Sign Permit
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OF RECORD (Namc as shovm on deed, mailing address, one and fax #)
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2) APPLICANT (N=e, mailing add,e�ss,� e an �i 4) VT_ ��`� �t 1 K
3) SIGN LOCATIONtONCin/l
cllude bussin/e'�ss4�namf c, ja�d,.d�regss�,p& phonee� #): V J���
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and lax f}:
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7) DATE OF BREKTI.ON
S SIGN DATA
WALL SZCrNS (list size in sq. ft., Mumimtion, & ."a FREE-STANDING SIGN
such as panel or cut-oxg letter
1. ! SIZE (in sq. fi.): 5 , 5--
OVERALL HEIGHT:
SIGHT ABLE 'WALL. AREA (in sq. fQ: TYPE OF 1LLUMINATION:
must be a'ubmitted illustrating the color of the sign
noting the dimensions of each sign.
9) DATE OF DESIGN RE PPRO�L (if applicable):
10) Applicant Signature: Tate: "
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1.1) Signature of Land/Duilding Owner: Bate: �i' 1�i
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Do not write blow this One
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FCC: lication: Rejected rove
Code Uificer Signatu
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64 in
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