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HomeMy WebLinkAboutPermit Permanent Sign SN-06-62 - VT DERMATOLOGY1Y OF SOUTH B U S ILINGO IP�EP_AR,`I EFTT -0F PLANT \TMIG & 0I,\T1�TF' 576 DORSET STREET SOUTH EiJRUNG ON, VEaR" 1? I ONTI 05466 (802) 846-4166 MAJX (802) 846-4101 Penr�it Numbe� STET- v"' - v �QC' Applic lion foi- Perm anent Sign Pen -nit ?) OWNER OF RECORD' (Nance as shown on deed, mailing address, phone and fax>#) ciyr.2.�0� f.LC- Lci s c r L L.L A --FA 1 r LLc ' ScJ /i�•pl S7f- �w V -1 S 4 b 2) APPLTCANT (Name, mailing addriyss, plio e, and fax $� �:� fib,_ ✓r- as-q.v i `�c� _ 6 9q � B � d' � � Z.. . 3) SIGN LOCATION (include business name, address, phone #): Uer-,,a-,t 3� y �•rre dt ,J- - S, 6 S_� 6 9 4) TAB'. PARCEL ID # (can be obtained at Assessor's Office) d 676 - d © 3d 5) SIGN ERECTOR (1',Iame, mailing address, phone and fat.#): 6) DATE OF ERECTION 71 TGN DATA Pl/ /Ob WALL SIC>NOS (list size in ,q. ft., illumination, it type FREFE-STA-1,1DII' G SIGN such as panel or cut --out letter) 1. SIZE (in sq. ft.): w 3 a S {'t 2 OVERALL IAEIGJ : 7 SIIGNABLE 'SNAIL AREA (in sq. ft.): TYPE OF IL LUIVII CATION: a rrzmn_ .� .�;,�, mow•--�� ­.Eu.,x " U, uuuii plupuseu sign must De submitted illustrating the color of the sign and noting the dimensions of each sign. 8) DATE OF DESIGN REVIEW APPROVAL (if applicable): 91) Applicant Signature: Dale:. + f '^`d % Igo not write below this lime �sease.�ssesseas�g�svesmavassveassas vvaaevsssosssgassasssassseoasevsyssas�gssae ssssswvvgaeassseva Fee: icatian: ected Approve v d Code Officer Signature: 4/ � Date: Appr. 6' FARRELLTREET DERMATOLOGY VERMONT DERMATOPATHOLOGY in C