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Permit Permanent Sign SN-05-11 - VALCOM II
DE-'F1A ,�TM,TL� 1 C)F FL''iNEIG ,& ZONPJG 576 DOFSET STREET :SOUTH BURUNGTON, VEMf1ONT 05403 (802) 346-4106 FAX (802) 846-4101 / Permit Number SN- 05 I ApplReat 0n Tor Pei • 11a.-Ient Sig Permit 1) OWNER OF RECORD (Name as shown on deed, mailing address phone and lax #) �<3 � N341rj 5, boS6- Sa06 2) APPLICANT (Name, mailing address, prone and fy S`6 3 1`%-S-oS w,11IS:zd IZJ, - J,o , k- ))A\ V\ nS\kn j - 3) SIGN LOCATION (include business name, address, & phone #): s oa " c 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 1 V 0 r D l V S5 5) STGN ERECTOR (blame mailing address, phone and fax #): S�o ��M W IN - P 33 3a13 :� 4 S -- t7 S`� d305 b) DATE OF ERECTION\ 7) STGN DATA. WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING SIGN such as panel or cut-out letter) 1. r _ 10 pr. SIZE (in s�. vN0eq- 2. OVERALL HEIGHT: 1 e>NLY W, S6v4s SIGNABLB WALL AREA (in sq. ft. ): TYPE OF ILL' 1 ATIOi - 1N.erNv\\.- EA-\T;,.�--. NOTE: A scaled rendering of each propo7d'g\n must be submitted illustrating the color of the sio and noting the dimensions of each sign. tL`iZ 8) DATE OF DESIGN REVIE P /%IAL (if applicable): 9) Applicant Signature: ''r Date: 0 _.— tO) Signature of Land/Building Owner: ti4JA -.u.zs�,r,ara..ne...as.a.-un4�.: �s�wan.��.a�enw�.•inwaa.aeec�eanoaam arA:��ef F�����6ac5fJl]000ANwltiW Dad OO•.J890009080©® 9flO�i£3®009�J ias:ss�o.�eae:.»oaoa�eaa�®o�fl^.Kn<. i"tee: Mode Offcer Signature Do not write below this 3ine rce.�d©s��m�.�o�aaaa�aaa�®aao��sa�ma®�e.sasa�z�e ae®�asor��a�w�oa ?ication: �ected Approved. L 7" ( Date: 3klb �� f �L I< r W Y� d 1 d N s -� Z T`1PE t:2 S % N % S N `N S `lam . C� i $ S s �!v ��\ s �� U p �b\� 5� �� \ �� N��� L� S� ,, l;m NA q p S� ' rJ MPR-11-2005 03:04 AN F1.01 OW Williston Road South Burlington.VT 05403 Tel: 802-963-4583 Fax: 802-M3-3493 tj C' IL ET- fy v W 01