HomeMy WebLinkAboutPermit Permanent Sign SN-10-17 - SHELL1 Permit Number SN-�-
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing ad re ss, phone and fax #)
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2)
3) S
, mailing address, phone and fax #)
LOCATION (include business name, address, & phone ft
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
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7) DATE OF ERECTION Z'� Cy�l ) .,4., a g / 3 —I S —
81 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter)
FREE-STANDING SIGN
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1.
SIZE (in sq. ft.): sF
g
2.
OVERALL HEIGHT: `
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
N V 1 h: 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 REV IE APPROVAL (if applicable): /11,14
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10) Applicant Signature: L`'� Date:
11) Signature of Land/Building Owner: C// / •C.li��, Date: Zo/
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Do not write below this line
Fee: ication: ejec d C,,kp__�prove
Code Officer Signature: Date: U G
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