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Permit Permanent Sign SN-04-24 - MERCHANTS BANK
575 EGFS ET STREET :SOUTHT EUFLLNGTON, VERMOINTT 05403 (802) 346-4106 FAX (802) 846-4101 Permit Number K- Oy Jy— Application lfbr Pe=,naiaent Sim Permit r'��t cl�a1) OWNER OF RECORD (Name as shown on deed, mailing �a�[ddress, phone and fax #) Cwt-"�S C, S C \ C, O � ^ ( CX 1 `JU r E r I IMWAN ON / 3) SIGN LOCATION (include business n e, address, & phone #): K'erAd-,.+S E>p,0 _ l7 ��lP Ls �04 4) TAX PARCEL ID # (can be obtained at Assessor's Office) I bQCD 00S(p 5) STGN ERECTOR (Tame, mailing address, plione and fax #): SRItwwc� �7i-6K) �Mpu�y b) DATE OF ERECTION '992 ' 7) STGN DATA MALL SIGNS (list size in sq. ft., illumination, & type such as panel or cut-out letter) FREE-STAl`TDING SIGN 1. SIZE (in sq. ft.):/ 2. OVERALL E EIGH T : SIGNAELE HALL AREA (in sq. ft. ): TYPE OF ILLUNE NAT O� - I 1 7DOLOA (4 i Iuuresd•�Qi �11� 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 REJnO APP VAL (if pl cable): _ 9) Anplic;ant Sienatur Date: 10) Signature ofLand/Buiwner: � Date: �� i0 WB09�A90Bt30�0E19Er"J99®03©®7a99©090.)O®bN9G906�300000®©O®000�GC1OJ00c90�9000NFM�JO©G01D03®000J090:90+T0JG�£90090®9 Do not ;write Mow this line acatei�ovn:sa4maaRuaeaj.;ea�cyteesdFee: ;Vic oea�rx,maeaaeoer reog�vaead�a�aaus Code Of icer Simiature: zDate:�;AOIV i 65" 3- S AMM.Ei S•I•G•N COMPANY 95 Chapin Road • Esse:; i:cnter ♦ Vermont 05452 (802) 879-3360 I approve this artwork as submitted. I understand that any changes or corrections after this approval is signed may result in additional charges and I agree to those if necessary. Approval Signature Date