HomeMy WebLinkAboutPermit Permanent Sign SN-08-41 - SPINAL CAREMR,
1 Permit Number SN-y(/ - q
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (N the is shown on deed, mailing address p . one and fax #)
22
.- t t
Y: (v Q�
2) APPLICANT (Nance, mailing address, phone and fax,#) F11rl ;-C
3) SIGN LOCATION include business name, addresr,, & phone
4) TAX PARCEL ID # (can be obtained at Assessor's Office))2)y 0,300("�
5) SIGN ERECTOR ame, mai( g address, phone and fax ft
7) DATE OF ERECTION
8) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut -put letter)
L
SIZE (in sq, ft.):
2•
OVERALL HEIGHT: l
Q
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF �LLUMINAT ON•
+.�. ■ .. n a'atcu tcttucttttg V1 tac
noting the dimensions it ptuposeu sign must De suDmtitea mustratnlg the color of the sign and
sions of each sign.
9) DATE OF DESIGN REVIE W, Afl'RQVAL (if applicable):
-7
t
10) Applicant Signature: ( Date: 1
11) Signature of Land/Building Owner's �� Date: !t U
aaa*raaaaaaaaao►orsoro#assrasas*oo'oi00000aae*aaaoaaoasssaoasaasssossssasassoa�
Do not write below this line
•rrrrraaar••asaaaraasaaaaraoaaaaaaaaaaraaaaH4laaaaaala!la4aaa!$#ar3att•!�s9a�r
Fee: �40ication: Rejected pprove
Code Officer Signature: Date:
�i
V t 900Z_LL_Zo £17-9Z 14 ewejeubjs 6Z£9£9 eoe
Spinal Care
Decompr
on Center
Dr. Laura A. Ramirez
9-2- W �(," WID14+
Steven Bushey
1 A N D C O M P A N Y
f
GETr
i I ,, 0%
DC
Physician�t