HomeMy WebLinkAboutPermit Permanent Sign SN-06-05 - POULIN PERFORMANCE1 /11TM i F SOUTH BURMiGTO1`J
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575 DORSET STREET
SOUTI-11 BUR L GTON, VERM-11ONT1 05403
(802) 846-4106
FAX, (802) 846-4101
Permit Number SN- 6)6 -
Application for Perm- anent Sign Peimit
1) O R OF R4CORD (Name as shown on deed, mailing address, phone and fax #)
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2) APPLICANT to ame, mailing address, phone and fax #) e v) of ✓ . J-o ✓
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3) SIGN.LOCATION include business name address & phone #) y
4) TAX PARCEL ID # (can be obtained at Assessor's Office) _
5) SIGN EPA ¢¢
ECT'OI T'IaYne, m�.ilin address, phone and fax.#);
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6) DATE, Or ERECTION
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or letter)
;cut-out
i. 1--✓ tA
SIZE ft.):
2 • ,,2_
,2 9 ' �r O �,� �
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
N � -?-
TYPE OF IL LUNIINATION:
p
N u i r,: A scaiea renaering or each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
8) DATE OF DESIGN
9) Applicant Signature:
(if applicable):
—O`? ` 7
Date: !
Tanta- 1. 141. /1 a
Do not write below this line
/Appra
oved
aaaeow®ae�R.e*ec�ted
,_Cade Officer Signature: Ll Ii'at;.. � (0'
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