HomeMy WebLinkAboutPermit Permanent Sign SN-07-92 - PSYCHOHERAPYPermit Number SN-�L� ;2,-,
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City of South Burlington, Vermont
Application for Permanent Sign Permit
1) O j ER OF RECOR (Name as showp on deed, mailing address, hone a�i d fax #)
2) A LICANT(Name, mailing address, phone
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3) SIGN LOCATION (include business name, address, & phone
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) 33
5) SIGN ERECTOR (Name, mailing address, phone and fax
7) DATE OF ERECTION
8) SIGN DATA
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WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter)
FREE-STANDING SIGN
I.
SIZE (in sq. ft.): •7 F
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2.
OVERALL HEIGFU: .�
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLLWINATION:
NOTE A seal d d '
e ten 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: Date: / of �U _0-7
11) Signature of Land/Building Owner: , Date:
Do not write below this line
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Fee: S 1' ation: rovelc;� C
Code Officer Signature:
Date: W
rep;
10
SIVA,
Victoria Colvin, uCiW, LADC
Dan Sleinbauer. wry. LA"D"C...
Emily D.Ttiurber. MA
S r dh F. Seats. MS. NCC
16-6.