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HomeMy WebLinkAboutPermit Permanent Sign SN-05-07 - WILLIAM A BURNETT CPA1) OVINER i DEF AR- T11V �1. 1 OF FTIUITNIHIG & i7,01NPIG 575 DORSET STREET :SOLD BU LLNGTON, VER-TViONT 05403 (802) 346-4106 FAX. (802) 846-4101 Perm it Number a nT-� AppliCation for Pei anent, Sin Permit RECORD (Name as shown on deed, mailing address, phone and fax #a l- 1(nVy� [Ey/1��r«y%^h 2) APPLICANT (Name, mailing address, phone and fax #) 3) SIGN LOCATION (include business name, address, &. phone #): W l hh� A - &Ar^cif C G P A of VkMDA &A`G-, Met work 4�- 100a I,.JiM$%lzt> �l �- 4) TAB'. PARCEL ID # (can be obtained at Assessor's Ogee) 18 10 — 0 2 00 Z 5) STGN ERECTOR (Name, mailing address, phone and fax #): F V\ S T , A IT(- 6) DATE OF ERECTION N5 7) SIGN DATA MALL SIGNS (list size in sq.11., illumination, & type FREE-STAl`TDING SIGN sucli as panel or cut-out letter) 1. SIZE (insq. ft.): T 2. OVERALL EEIGHT: % FT SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLLTiYIIN,kTION: _ I Ov,(\C NOTE: A scaied rendering of each proposed sign must be submitted ilhMrating the color of the sign and noting the dimensions of each sign. 8) DATE OF DESIGN REVIEi PROVAL (if a plicable11- 9) Anplicant Signature: 10) Signature of Land/Building O-nvner: � L' :aaweuaaoao®nm�©oe®o�oo®©ao®�n��oso�©e�ca+�e3®®flamoao®o es�o��uo "'�a'u©ueoo e�� Do not write below this line Date: Date: 1 �8 /$J�oiS61iC3C 32s ^ d3 a�U?I J€/3 ®S®adOL 8. �9uL�®98:AJa�3A 46*4 i33 c�sg W�3 �v BeeH® ��T@S��vFi iyo swap I Fee: _ n cation: cte ' Approved iode Officer Sig-mature:Date: 0 z- S ;S �-, 3 o - ,- rA s yw � J/ IeA (14zt