HomeMy WebLinkAboutPermit Permanent Sign SN-04-59 - TUMBLEBROOK DRIVE-DEP FEMN E-i 1JT OF P1-,A - TI1NTC7 &' 17fOT^TILNG
575 DOt'SET STREET
SOUTH BUI L;LNOTOiti, VERD/101'4T 65403
(862) 346-4106
FAN. (802) 846-4101
Permit Number SN- 4 _�
Application for Permanent Sign Permit
1) dO;v� NTER OF RECORD (Naive as shown on deed, mailing address, phone and fax #) V-r
2) APPLICANT (�,Tarne, mailing address, phone and fax #}
3) SIGN d LOCATION (include businesname,j address, & phone #):
4) TAN PAFCEL ID # (can be obtained at assessor's Office
5) SIGN ERECTOR Q,Tame, nailing address, phone and fax, #): SgLl::—
6) DATE OF ERECTION
7) SIGN DATA
0
WALL SIGNS (list size in sq. ft., illumination, & type
FREE- STA' IMDING SIGN
such as panel or cut-out letter)
I.
SIZE (in sq. ft.): CT-
2.
OVERALL HEIGHT:
Lq .5u x
SIGNABLE WALL AREA (in sq. 1):
TYPE OF ILLUNUNA T ION:
DMF1
NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
8) DATE OF DESIGN
9) Applicant Signature:
APPRO(if pplicable):
Ili) Signature of Land/ —Building Owner:
Do not write below this Bate
Fee: S Application: elected
Code Officer Sig�-nature,: )`" �v
Date: 1
Date:.. A l' . z I a
YApproved 2,
Date: //0� / �
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