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HomeMy WebLinkAboutPermit Permanent Sign SN-04-65 - 435 DORSET COMMONSI$o 4 . i 1 1 �.J ''�T1"1 rI 'lJ� yL, s�T' �' 1T DES �F�1/I T OF FLAi`TT�TMM1� i �,U-\T]It`li� 575 DORSET STREET :SOUTH BU-19LLNGTON, `�ERDAOINT 05403 (802) 345-41Co F,A]r (302) 846-4101 Permit Number SN-6 � - 6 5 Application for Pe &neat Sign Pe It 1) 0WINTER OF RECORD (Name as shown on deed, mailing address, phone and. fax #) 2) APPLICANT (Name, maili g address, phone and fax #} i .alit, .� Yi7 tr i 3) SIGN LOCATION (include business name, address, & phone r2,w t- � 4) TAX PAR.CEL ID # (can be obtained at Assessor's Office) 5) SIGN ERECTOR (Kame, mailing address, pl)one and fax #): 5) DATE OF ERECTION 4 h;&1 J 7) SICTN DATA `BALL SIGNS (list size in sq. ft., illumination, & type such as panel or cut-out letter) FRI ,E-STA-1,MING SIG I. �g�T. SIL(in sq. ft.): /� � 43 1 2. OVERALL BEIGNT: FT SIGNAELE WALL AREA (in sq. ft.): TYPE OF ILLUNHNATI N: NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. /f 8) DATE OF DESIGN REVIEW APPROVAL (if applicabie).- J a' � � 9) Annti=cant Si�;ature: u_,,az �"' Date: , 1 { r '���,M1 i 10) Signature of Land/Building Owner: F '' ,z+rr� &161-1. Date: �aaceaeoaaee®da®ua®a;�e®o�®000aooeo9®ebaAe�e®oaoaae©c�®aau9oaoaceuoae©oweanw©0000�e®eac�0000c�®ana�©ao a®ee Do not -write below this live aaeasn�ea�a�r we �a�on��a�c�swe��®.pan a aews�c�4a�o�av:�aa-aeyanueseaeea�bn���eea�aewa�ae�d:+aa�e�w�a�eae��w®��� Fee: S Pltdatic'n: e e^ted _ approve:? Code Officer Sig7atur�,. �5 V I IV Y 2 Dorset Comma m ELM7iTl '0" yr"atom goad $0. Eufongtom VT 03403 poem+:f7.6223 + t4■ ""324 606� ctpnrr�mrvtFam