HomeMy WebLinkAboutPermit Permanent Sign SN-09-12 - SHELLPermit Number SN- d - �.
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
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2) APPLI. T (Name, mailing address, phone and fax #)
3) SIGN LOCATION (include business name, address, & phone #):1,VXot'�,'��
4) TAX PARCEL ID # (can be obtained at Assessor's Office
5) SIGN ERECTOR (Name, mailing address, phone and fax ft CKeiv&I.2 C'Z>
7) DATE OF ERECTION
8) SIGN DATA 6� _;(/ST, JNq h , t i_
WALL SIGNS (list size in sq. ft., illumination, & type
— r4s-A-1 c
FREE-STANDING SIGN
such as panel or cut-out letter)
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l �, Z �'� l(10 v - / &"1/1" ,
SIZE (in sq. ft.):
2. 11TR 51,e/l lkl,17 0�t% e,1Wj1d,4 61s,
'OVERALL HEIGHT:
SIGNABLE WALLAREA (in sq. ft.):
TYPE OF ILLUMINATION:
NOTE* A 1 d d
sca a ren enng 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: �/,f Date:
11) Signature of Land/Building Owner: C:. 2-� Date:
•...............................................•..•....••.•......•.........•.
Do not write below this line
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Fee:y Ap ation: Re' cte 4ro
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Code Officer Signature: Date: /