HomeMy WebLinkAboutPermit Permanent Sign SN-05-30 - HERTZJun-06-05 10:13 From -Hickok & Boardman +1 802 658 7616 T-895 P.002/002 F-225
CITY OF SOUTH BURLINGTON
D ,PAR, , 'WMN T OF PLANNING & ZON-OTa
575 DORSET STREET
SOUTH B'URLLNGTON, VERMONT 05403
(802) 846-4106
FAl`I (802) 846-4101
Permit Number SN- ��-
Application for Permanent Sign Pemalt
1 OWNER OF RECORD phone and fa ; fi)
(Name as shown on deed, mailing address,
ce11 , Y3-7q'T9
2) APPLICANT (Name, mailing address, phone and fax 4}IQ �S
3) SIGN LOCATION (include business name, address, & phone 4):(j'-��
4) TAX PARCEL TD # (can be obtnincd at Assessor's Office)
5) STGN ERECTOR , ame, mailing address, phone and fax 9): iw
6) DATE OF ERECTION
7) STGN DATA
WALL SIGNS Oisi site in sq. ft_, illuminacion, & type I FREE-STANDLNG SIGN
tt
such as panel or cut-out leer) _
1, 3sr 1 %' YS 5 wire w1y SIZE (in sq, ft.)::i'
, 3o S.F.
2_ OVERALL I -MIGHT: , jGr �11
SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMNATION.-
NO'I'>r: A scaled cenaaring of each proposed sign musT be submined illusuatmg ,ire color of The sign and
noting zhe dimensions of each sign_
8) DATE OF DESIGN REVIEW APPROVAL (ia applicable):
i
91 Abnlicant Signature: c- % Date:
0) Signature ofLand/Building . wne pate: G S 7 7�;4,
oyoDOVapNmeeaseoo9aocvv0000 aaeso0e0oo0a09Y0076• eoBOa OOa0000pYuoaoaeuooeeee•eB000ea000Aao00 eeeeev
Do not write blow this line
9vO�se�eVeoe�a eaY•iUoeaaYaaYsoeee00� aoaaoaaaaoeaaaae�eoeaaaeeoeeaeeoaeeea�asooa• oe0eeueee0a�7ee
Fee: W A plication: sec Approved
Code Officer Sip, ature: late: G v
! 'd S�O�'ON SU3IS ;j?2S diM; hvN.E SOH '9 'unr
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