HomeMy WebLinkAboutPermit Permanent Sign SN-05-52 - KUMON-MY OF 30 U TH E U R. LUINGTOIN
DEPRA�TYM, NT CAF FLAi11F1'TH`1TG & Zjf01`TTU'TGr
576 DORSET STREET
90t7l H BURILLNGTON, VERDA 01`7L 05403
(802) 346-4106
FAJ", (802) 846-4101
Peri-rilt Number S-tT- 0
Ap ., plication, T'Or Pemiarient Sign Permit
1) 01WINTERA OF RECORD (Name as shown on deed, mailing address, phone and fax
- (,kAr lei -72 7 VT— C6qy-?-
-99E- -3�7-7 E-Ix' 6 s-K -
11' A i PPT-1CA1\U (Niarne..-fiailing address. nhone and ;'VUK r—c-
3) SIGN LOCATION (include 'o,,s_1';1ess name, address, & phone #): B —
4) TAX P .`,RCEL 11D -1 (can be obtained Assessor's OfCze)_. i —700 —00 0 q-s-
5) STG-JEREC TMR (Ir4ame-, ri;.Ifing add-res.,,, 1p%orle a fats 9): -Aw ce4
U
6) DATE OF ERECTION � 2� Z-.
7) SIGN DATA
WALL SIGNS (Est size in sq. ft., illumination, & type
such as panel or cut-out letter)
FREE-STANDING SIGN
1.
SIZE (in sq. ft.):
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
z 14 rf - T4- I
TYPE OF ILLUMINATION:
N one-
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):
Signature: nDate:
9) Aplicant Si
I — - dZ4
10) Signature of Land/Building Own ate:
Do not ;write he w th' ine
Fee: �lication: R ect.eU eApproved
Code Officer signature: ire:
No Text