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Permit Permanent Sign SN-10-12 - DOMINOS & KLINGER'S
Number 0 - / Permit Num rSN- � t City of South Burlington, Vermont Application for Permanent Sign Permit l WNER OF RECORD,(Name as shown, deed, mailing address, phone and fax #) 051691 2) APPLICANT Name, mailing s, phone and fax #)_ - aIA3�, J - 3) SIGN L9CATION (include business name, address, & phone #): OZ14i 410,S y%s C' yre f.� -"e Erg 3 �ta#a� 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 0&70 — ©00/ 0 5) SIGN ERECTO (Name, mailing address, phonand fax #): 6phone and 3 13uC� / 0L.-D "7 Cd // /,(,I ( IR 3 _ -0a7 ;P 1 7) DATE OF ERECTION ff2A4,(/ = 8) SIGN DATA WALL SIGNS (list size in sq. ft., illuminat.on, & type such as panel or cut-out letter FREE-STANDING SIGN 1' T�cy✓Vlt�X71 S/Z�- SIZE (in sq. ft.): S 2. j ( � ,� � �n l� r C h n� ' OVERALL HEIGHT: SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: 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: `l / ��'�2 '-�-�� Date: ',2-0/ 0 11) Signature of Land/Building Owner: 2 0LI/i S Date: °// ' 3L0/(D Do not write below this line •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Fee: O p lication: Rejected 6ppro Code Officer Signature: Date: �IX#D m "ll'i III111i =iL=!tpm M MAI M M;i J' M. ' A. WiI No Text >C � C