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HomeMy WebLinkAboutPermit Permanent Sign SN-04-22 - CHAMPLAIN PHOTO516 DORSET STREET SCC7H, BURLINGTON, ,.iERM OP -TT 05403 (802) 546-4106 FAIL (802) 346-4101 Permit Number SN-yLA -U-1— Appheati on for Permanent Sign Permit 1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #) ,7AL� ?�uz�tiT 2) APPLICANT (Name, rriaiii g address, phone and fax #) 1i A,' PAOTD 1�y0 wi4LiSWN te! : so, alp, �A-.l V7- 675-ye3 3) SIGN LOCATION (include business naane, address, & phone 46, 1113ov'e 4) TAX PARCEL ID # (can be obtained at Assessor's Office.) S/ O O JI L�q L 5) SIGN ERECTOR (Name, mailing address, phone and fax #): ��(�Mby�,c,e 376 M,c dpw ,Og ve . &3 ems! 4. v7- seZ - A63 5 1 a) DATE OF ERECTION .5— a 3 — O y 7) STGN DATA WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING SIGN such as panel or cut-out letter) I 1. SIZE (in sq. ft. ): l 6 , 3 2. OVERALL HEIGHT: oZ fl_ SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: A/ 4Ne 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 REVIEW APP OV p licabie): 9) Applicant Signature: 10) Signature. of Land/Building Owner: aawaoaa000moau000eoaooeoa0000a�ooauueo�eaeeeoaovoa�oo®aa000© aeuwan®oo©0000000ao�a Date: S-so? / -O `, Date: 5" a / - c 9' Igo not write below this live 1.0vaare"3aoa00050 ad0650400**C'QQae4a4o i4860044aeSR8e34eancaadaall asaea of®�3B�G9ea6c7+x]3�u Fee: 'jiplication: r _ejected Appro✓ed t od { 9ff�eer n �»atttre/A"�,�'Date Champlain Photo Lab Stud'10 1 Hour Photo - Digital Imaging - Passports Wedding Photography - Senior Portraits Pets - Children - Families - Sports VA".CHAMPLAINPHOTO.COM SPEEDE ;' &EARL'S Additional Parking at Side Entrance