HomeMy WebLinkAboutPermit Permanent Sign SN-05-19 - STATE FARMPermit Number SN- ��----�-1--
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) QWNER OF RECORD (Name as shown on deed, mailing address, hone and fax #)
O R S e T 5 %, Sv 77-e- 17 S a, RV/?4— NGTON, V T ar- $� 03
2) APPLICANT (Name, mailing address, phone and fax #)(fj/�ys-
/a o Ax e 7 .S // -7 '
< 6 . 12c/ /' /r r' 1J #0 3 6s^7 - 3S-zso 6r'7 - 3-r 9-r
3) SIGN LOCATION (include business name, address, & phone #): S 9"'r 7',' / 7 /1n,
l GO 4 oll ref <77 so-00
4) TAX PARCEL ID # (can be obtained at Assessor's Office) 0 S % D r D oy 00
5) SIGN ERECTOR (Name, mailing address, phone and fax #): NO F be? err I %/Y�'�
7) DATE OF ERECTION 7, 3 , 1� ,
81 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
1. WON - /LZNP,1,70
61.
SIZE (in sq. ft.):
2.
OVERALL HEIGHT:
SIGNABL WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
pax rs'x 2S-I
NU It:: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN REVIE APPRO (if applicable):
10) Applicant Signature: Date: o S
11) Signature of Land/Building Owner: Date:
Do not write below this line
Fee: 4b Ap cation: Rejected
Code Officer Signature: Gt, Date: f
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