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HomeMy WebLinkAboutPermit Permanent Sign SN-06-63 - INTERSTATE SHELL0' -, e?2 C-ITY OF SOUTH BURLINGTON T .T T,_ TG 575 DORSET STREET SGTL,—i,FI BUF-L,I GTOIT, VEP,P.�0I\T-P O54C3 pp(802) 346-4135 FAX- (802) 846-410.1 . Permit Number Application for Pen aartent Sign P*ermiL l) O dEER OF RECORD (Nape .as si-io,,N•n on seed, mailing address, phone and. fax #) 2) APPLTQ 4ANT (t Tame, mailing addriYss,-t)l1one acid fay #) L 5 re,-,4ic u 3) SIGN LOCATION (include busing s : arne, address, & phone ##): _%/72G-I I7x177-- Ulte-`U- /v 5 5 1,611 L Lr ,u 4) TAX PARCEL ID # (can be obtaimed at Assessor's Office} 5) STC�N ET;ECTOI (i'l c, �,i ilia�g address, phone and fa=s.�#) �GU.0 'OCR 6) DATE OF ERECTION g— / — 06 7) STGN DATA �� x !S' T� ,� f',ci� �► _ c .a 1-,� ) WALL SIGNS (list size in sq. ft., illumination, type FREE-STARIDING SIGN such as panel or cut-out loner) ,,C/-511 l — Afv C-41-4AY4, if 1, Z5,5F1 X% Ai SIZE (in sq. ft.): 2. OVERALL IMI(TH : SIGNABLE WALL AREA (in sct. ft.): TYPE OF ILLLTiViNATION'. TTd'arM A ....-1 -3 __._ � _ _• --.= �. n � .aieu Teducx,ng or each proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. 8) DATE OF DESIGN REVIEW APPROVAL (if applicable): Q) Applicant Signature: ,C Date:. i C?, SSignat ipe !of T a�fl�tli3cjin�� er' Z —d wem$a�aamaam®c�oao®se©000�ammmooaao©o®o�eeaesst�aoc�a®o®®®e�mr�®�®oa®®c�®®®oae®m®®o®oa©as®®©ra®®poc�ea®e®©�o�ae® . Do not write below this line �1 Fee: Code Officer Sigpature: 90®>i 698a®9�0�9Yi0A904.t4 Approved Date: % Y(� tjC-�pil,� +C `nA a t,_e ✓'S k 5kes+- d7 -"a PN C(a V -,{ hi 3.4z 4-,& V",-%. Je. `� 2-) PAK C --->Ti- AJ4_> " 3,�5' / L,,:l(,ei T-1