HomeMy WebLinkAboutPermit Permanent Sign SN-05-36 - MAMA MIA'S PIZZA07-12-05 01:21pm From-ACADIA REALTY TRUST
5167678834 T-126 P-002/004 F-128
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575 DC) SET SMXET
SvLT�i BURL�INGTOIti, 'TFMA01Nr' 05403
(302) SA-6-4106
FA7 (QnO% 246-d1G?
Permit Number ShT -
pplication ier Perm anen-t Sim Permit
1) OWNER OF RECORD (Name as showm on deed, mailing '•cress, phone acid fax #)'
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St"fc 2&o Wkl fie. r4
T. 6114 zoo g 16V ,F-r-T1<.f- $mod 23ev
2) APPLICANT (Name,'nailing address, phone and fax 4)
3) SIGN LOCATION (include business name, address, & phone #):
gl
4) TAX PM-CEL ID # (can be obtained at Assessor's Office
5) STGN ERECTOR Cc',iAme, maiiinR addf ess, phone and fax 4):
b) DATE OF ERECTION
7) STGN DATA
WALL SIGNS (List size in sq. iL, i jwnination, & type
FREE-STANDING SIGN
such as panel or cutletter)
I
I
1-out
.S= (1I1 Sq. ft.): k.
OVERALL HEIGHT:
SIGNAELE WALL AREA (in sq. ft. ):
TYPE OF ILLUNRNATION:
,3
NOTE: A sealed rendering of each proposed sign must be submitted illusttating the color of the sign and
noting the dimensions of each sign.
8) DATE OF DESIGN REVIEViT APPROVAL (if applicable):
9) Applicant Signature: 'lj Date: 5 if 9 G
10) Signature of Land/Building O r Date: a3�
jAoved
oo notwrite Wow thisline
0 Ai�MFee: Ica ej cted ppr
Cede QtF+cer Si�natur� Date: /
'd E*66-986-208 gsaM a.UTTO eLE-60 SO
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