HomeMy WebLinkAboutPermit Permanent Sign SN-05-53 - SHORT STOP - JOLLEYFROM : City of So. B
FAX NO. : 1 802 846 4106 Rug. 23 2005 10:09AM P2
SO ,'z- .PURLD' iGTCN, VErR-1�1_`ON' 0,5408
802) 846-4106
. r� (802) 2:�'_-6-4101
Permit Nusnber aN-�- J ✓
Apphcatio z 16o.r pen-nanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, in4ing address, plane and flax #)
l J-Ass� 44, PO g� -L, SA( 4" V*-
2) AYPUC..�I<[T (-KartZ3 wiling address, ph-cne and fax
3) SIGN LOCATION (include business i1mne, address, & phone #):
4) TAX PAP C EL ID #- (ean be obtained at Assessor's Office)_
S) SIGNT ERECTOR QTame, mailing address, phone and fax #):
2
Lf
J
6) DATE OF ERECTION
7 STGN DATA G00'voP'r-
WA: L SIGNS (list size in sq, ft„ illumination, & tyre
such as panel or cut-out letter)
F.R-FE-ST IISTOINCr SIGN
_�...._-._,.-
I .'f K Z`i l L G6 i iv`r� 4c-c-`�'
STYE (in sq. . )-
2.
O �� �• e GH
wVl.:i�1..t..�.L.
SYGNA .LE WALL AREA ,q_ .):
TYRE OF Ii,I 71�iiINATIC�I�T:
NOTE: A scaied rendering of each proposed sign rmist be submitted illustrating the color of the sign and
noting the dimensions of emb sign.
8) DATE OF DESIGN RE . APPROVAL (if applicable):
9) Applicant SigmatuTa: V���i..�— Date: b(`4'
IO) Signature of Land/building OwnE;r: „
aoemnwoaoamDo�9btliatltl�o6mDootlt9omotaaOwoaroodoNar+DOofJar9YNtlog7000aamaotlWom®moDamoda,omCod1000DOOObtlAWlAW bdOCh06yObo
Do Qeot Wl ite below this line
Fee -
Code Officer Signatum:
uu��;-T-
C=Y, OF SOUTH BURLINGT-0-114
E)E1FAR,T11\/1E41'171 , D-F PLA-1-T!-\TE",TC-t &A �ONYNG
576 DORSET STREET
S0171H. BURILLNGTON, VERM-110�71 05403
(802) 346-4106
FAJI (802) 846-4101
Permit Number SN-
Application for Per-rnartent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax
-5-
--)o A�,-Soc--i44s:s Pip Sox 6W -c-+ V4- o Y)g
2", APPLIC., mailing address. phone and fa -A
C> VIC
3 3) STCN LOCATION (include business name, address, & plionc.
TAX PARCEL ID # (can be obtained at i35sessor' s r',ffiice)
5) ':INN ERECTOR (Natne, mailing address, phone and 'f
-5) DATEI I Llc� k.�l
OF ER. (0N— c7 T-
7) SIGN DATA
WALL SIGNS (Est size in sq. ft., illumination, 8-, type
FREE-STANDING SIGN
such as panel or cut-out letter)
1. 1 %
1 Y61
SIZE (in sq. ft.):
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF U-1-LadNATION:
I 0-t^t- LA.' Ar� A— (0'1-"--'
NOTE: A scaled rendering of 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):
9) Applicant Signature:Date:
-
10) Signature of Land/Buiiding Owner:
Do not write below Ais line
F=: Application: E, Rejected 0 Approved
Code Officer Sip ,, ature: Date:
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SECTION B-B SECTION A -A
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SECTION B-B SECTION A -A
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