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HomeMy WebLinkAboutPermit Permanent Sign SN-05-41 - P G ADAMSl -4 IT I CT 30iJTH BURti1LINGT Oil `TT`tU`JG v� ��(�N]IT�TG 576 D RSET STREET SOUTH BURUNGTON, VERMONT 05403 (802) 846-4106 FAX (802) 846-4101 Permit Number SN- a Application for Pe anent Sign Permit 1�-QWNER OF RECORD (Name as shown on deed, mailing address, phone 2) APr--.J; f,", !% T (•dame, mail o phone and fax #) Y/- and fax #) 96-1 i'A.� SIGN LOCATION (include business name, address, & pion #): — 4) TAX PARCEL ID # (can be obtained at Assessor's Office ()M*O: C171,S -G 5) STGN ERECT(Name, mailing address, phone and fax 4": �� ' DOS ' �C ) DATE OF ERE '.TION—- 7) SIGN DATA WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING IGN such as panel or cut-out letter) 1. SIZE (in sq. ft. ): ZD 2. OVERALL HEIGHT: SIGNABLE WALL AREA (in sq. ft.): I TYPE OF ATION: 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/Building Owner: Date: oawr�uraaaoa9c�edc�o�eoaeoouo�ooee�ooso��oc�:e®a�®®oaau oW00000aoc.a�o�muoa®000e�+oaoocoo©�aeu0000c Do -;pit write Mow his iine �4ee• J ._ Code Officer Signature: •»»�ao»e+f�eo®»e»»aeo�ec+ aae��ecnane�»d®»a®eat ;test G� /V/ 05' i J Nu rat cl>a-195 toe oo