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Permit Permanent Sign SN-09-02 - 1775 WILLISTON RD
Permit Number SN-0 �- e> & City of South Burlington, Vermont Application for Permanent Sign Permit 1) OWNER OF RECORD (Naipc as shown on deed, mailing address,.phone and fax Fax: 80i• '&03•X31 2) APPLICANT (Name, mailing address, phone and fax #) SCim e, 4o(, RzuY( vl 4Wjj%1r O5f 3) SIGN LOCATION (include business name, address, & phone #): 44Citir)0jrbe_S of at, r22 (3 i tenants a.S Sllrry n on 4) TAX PARCEL ID # (can be obtained at Assessor's Office 5) SIGN ERECTOR (Name, mailin address, phone and fax #): � � S 1 FYI s 10l r1 S f 0C . P.o.aaF �5 70 Ess-e� , ✓T o545j 7) DATE OF ERECTION 8) SIGN DATA WALL SIGNS (list size in sq. fl., illumination, & type such as panel or cut-out letter FREE-STANDING SIGN 1. SIZE (in sq. ft.): 2 6? �- 2. OVERALL HEIGHT: .i SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: ' ewiv„drn d L (9 k3 NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign tnd noting the dimensions of each sign. 9) DATE OF DESIGN REVIEW APPROVAL (if applicable): 10) Applicant Signature: de66--S �WO_A o n Y g ate: l S- O 11) Signature of Land/Building Owner: w d,r- Date: 1, ( 3 Do not write below this line ••••••••••.••.•.•.•.••.•.•••••••••••••• Fee: A-plicatjbn: Rej�� j r . 6Approv Code Officer Signature: Date: / 1 UM ' Icv 1775 Williston Road 11-01 802-872-9906 ©zoo9 designsignsvt.com Temporary name panel January 9, 2009