HomeMy WebLinkAboutPermit Permanent Sign SN-07-56 - DENTIST - SPERRYD» 1A '.11. pTT r,)LFP 117I1TIdiG : OTrlrt'T
575 DORSET STREET
SOt�'14- BURL:fNGr.PON, VERA/ONIF 05403
(802) 546-4106
FAX (802)846-4101
Tern pit Nuanber
Application for Permanent Sign p&.
l) OWNER OF RECORD (Name as showm on deed, bna'ling address, phone and fax #)
2) APPLICANT {Mame, mailing address, phone. acid fax ##
3) SIGN LOCATION (laclude business name, address, & phone #):
4) TAX PARCEL ID # (can be'obtaiiied at Assessor's Offi� v) � (� .
'5) SIGN ERECTOR �r,1ame, 1 ihili
147 1 S"
6) DATE '()I'' ERECTION
pb e: and. fax.#): �0.✓ Lt G�,� J�T
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, � type
such as panel or cut-out letter)
1.
2.
FREE-STANDING SIGN
SIZE (in sq. ft. ):
®VERALL IIGET f/
SIGNAELE WALL AREA (in sq. ft. ): � � TYPE OF MLLTMINATION:
NOTE: A seated Aenderin of each proposed sign v1� ��
g P p gn must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
8) DATE OF DESIGN REVIEW AppROVAL (if applicable):
4) Applicant Signature: Date:.
Igo not write below this line
F
Fee: � �catic�n: . eje ted pprovz�
!Cgde Officer Signatur; : �,t p �, Date:
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