HomeMy WebLinkAboutPermit Permanent Sign SN-07-41 - NORTHEAST NEROLOGYPermit Number SN- Q 7 -V�
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) WNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax
3) SIGN LOCATION (include business name, address, & phone #): Aj6,v X ea0- Nit r Qt/.5 V, pLe_
o 5-4 o 3, Cal (Y"J) ,;24- 75-j6. i) Fx• kyi o>' 4UAX
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4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #): j< e ✓Sh r) er sl9ns crmd p-�4 4 P.64et
°j Mey �✓s �.t4;✓t, So. !�jiti'YL�,n.� � b'° 1' � 5 �l 0 3
7) DATE OF ERECTION A} Soon 6;a
8 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as ane or cut-out letter)
I.
6 !ems 10y 1jCca (Ww1 x 30 %)
SIZE (in sq. ft.):
3 /i X
2.
OVERALL HEIGHT:3��
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
&,* Vq
n on e.
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 7PRO Lifapplicable):
10) Applicant Signature: Date:
d
11) Signature of Land/Building Owneri% / Date: L
Do not write below this line
Fee: S plication: Re' cted <pp.rove)
Code Officer Signatur Date: // A
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