HomeMy WebLinkAboutPermit Permanent Sign SN-06-66 - POULIN PERFORMANCEPermit Number SN- 06 _ 60
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF CLO_KD (Name as shown on deed, mailing address, phone and fax #)
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2) APPLICa�vT Name, mailing address, phone and fax
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D SIGN LOC TION (include business name, address, & phone #): �o U i n
4) TAX PARCEL ID # (can be obtained at .Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax ft Ke IDS h U t�l S
7) DATE OF ERECTION
8) SIGN DATA
WALL SIGNS (list size in sq. 8., illumination, &type FREE-STANDING SIGN
such as panel or cut-out letter)
SIZE (in sq. ft.):
OVERALL HEIGHT:
SIGN a m ,rt W ALL AREA (in sq. ft.): TYPE OF ILLUMINATION:
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
10) Applicant Signature:
11) Signature of Land/Building Owner:
Date:
Date:
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Do not write below this line
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Fee: _ j A p ation: Rejected roved
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Code Officer Signature:
Date: 4
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