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HomeMy WebLinkAboutPermit Permanent Sign SN-04-28 - GET WELLDEPAR"TI`V E,1\T"1' rOF PLA1'MI EMM, & �,( NDTG 575 DOPSET STREET SOUTH BU]4LLNGTOI-i, VERMON71 05403 (802) 346-4106 RAIL (802) 846-4101 Permit Number SN- G'�'l - 1-r Application for Pe anent Sign Permit 1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #) 2) APPLICANT (Name, mailing, address, Tone and fa;, #) C� -P T L✓r l I �000 c✓;,/,4r Rc' Sa j�'i��sTv ✓r �S'1c? gvv 660 3/,'L, " �Uv`13G b 3) SIGN LOCATION (include business name, address, phone #): Sow 4) TAX PARCEL ID # (can be obtained at Assessor's Office) S� I P ` b 3 0 5) SIGN E;�.ECTOR (Name, mailing address, phone and fax #): Kra nr� Sr 2g �i oar 6) DATE OF ERECTION 7) SIGN DATA ley C-e--I--" WALL SIGNS (list size in sq. ft., illumina ' n, K type such as panel or cut-out letter) FREE- TAIS ING SIGN 1. SIZE (in sq. ft.): 2. OVERALL HEIGHT: SIGNABLE 'WALL AREA (in sq. ft.): � TYPE OF ILLLLUMINATION: NOTE: A scaled rendering of Pach proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. 8) DATE OF DESIGN REVIEW APPROVAL (if applicable): 9) Applicant Si onature: Date: % U 10) Signature of Land/Building Owner: Date: awwwewwwwc®neaoea®©a®®®eo®woo©®©s0000raewaeauc►aoc�aa®oo®mneoo®oe®sae®ne000wwowaoso®�somneo©oos®ffiwae©©oo®eWe Do notwrite below this line ivs6WaJ�9w80 90��4'.1.�a�SWa.�af3�daAcjeil«a�:,�:;i6a6.90�fsabi�.AWWaexv �u 3WabR8SG4aia'+. 0 an,920 004 aaPi GB�sad+DS �GxSti�uJWW�ees Fee: _ ion: ❑ Rejected _ _pproved Code Officer Sign atu Data: