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HomeMy WebLinkAboutPermit Permanent Sign SN-04-26 - INTERSTATE SHELLF DE-7,`DAF',,Tr\vfET\TT ,r.)E PIA, 11\T1\,TU\jkG & ZOlVlr-,TG 575 DORSET STREET SOL 1H BURLENTON, VERMOINT 05403 (802) 846-4106 FAl[ (802) 846-4101 Perr►;it Number S1,T--y-_A_ Application for Permanent Sign Permit l) O INNER OF RECQ RD (Name as shown ou need, mailing address, prone and fax #) I(Vl.�aAn/.-j""ti 6"/ C-s 2) APPLICANT (Name, mailing address, prone and fax #) 96 Y " 0) p _ r J, n 3) SIGN LOCATION (include business e�s�q�L Sal Ios;�- phone #): 460 - 9I/ 4) TAX PARCEL ID # (can be obtained at Assessor's Office 5) STGN ERECTOR r\Tame, mailing address, pl�or►e and Fax #): 6) DATE OF ERECTION 6.3-0 ?) STGN DATA (,%t 6 1,�,-/e 3 WALL SIGNS (list size in-sq. ft., illumination, 8c type FREE-STANDING SIGN such as panel or cut-out letter) 1. � iulei( S. n1 C SIDE (in sq. fit): % 2. OVERALL IiEIG SIGNABLE MALL AREA (in sq. ft. ): TYPE OF ILL UNt ION: rd, NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color o# the sign and noting the dimensions of each sign. 8) DATE OF DESIGN REVIEW APPROVAL (if applicable): 9) Applicant Signature: �(�r w-- Date: 6 - 3 -0 10) Signature of Land/Building Owner: � `�� � Bate: aeonwaa4ae®dewraeae©aa®®©oo®oowoa®Iwo®w©eaa®voaw�uaa®oo®aueoaooeowwo�aeeo©oosw00000ss©©oew®sowoasweoaooaemc n not write below this fine aas�a�e�s�.::awaa�s�saaanr�ee�,aaaoaea :w� e.-.ecssa�a:�.��wawvaa�as�neaoa���s��®��'a.:s�t�aeaa-eue�c��sa�saeeea�s Fee: �(/� libation: yle�',-_p-Cro_�ed Code Officer Sicmaturti: fv"� )ate: zy��)v