HomeMy WebLinkAboutPermit Permanent Sign SN-04-35 - IDXPermit Number SN- C) -
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #)
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3) SIGN LOCATION (include business name, address, & phone ft QX 5157LsM
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) 0 72S — OODD (=6-
5) SIGN ERECTOR (Name, mailing address, phone and fax #): Sae8vmba
7) DATE OF ERECTION WU44,ST /
8) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
1.
SIZE (in sq. ft.): S-t-
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
NOTE: 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
�f10) Applicant Signature; L r
11) Signature of Land/Building Ov
(if applicable):
Date: 7 / G^
Date: 7 -1S
Do not write below this line
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Fee: �Dp' ation: Rejected pprov
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Code Officer Signa e: ` Date: 711, U
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