HomeMy WebLinkAboutPermit Permanent Sign SN-04-04 - BOURNESFROM : City of So. B
FAX NO. : 1 802 658 4748 Feb. 17 2004 01:24PM P1
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575 .i): RSET STREET
SOIL-71T BU IX'4 TOi4, rE'+-�-,AAONT 0,5403
(802) 346-4106
Perniit Number S-N- v V.
Application Bor Permaneft Sign Pennit
1) 0V-TN R OF JUTgORD (Nacre as shown on deed, -nailing address, oho e and fax 4;,
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2) APPLICANT (Name, ;nailing address, phone and fax 9)
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3) SIGN I.,i�CFsTjION (incbudce business name,/address, i p )C/���.,,.
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4) TAX PARCE1, ID # (can be obtained at Assessor's Office
5) SIC:rN FRt✓CTOR (I1ame, rnailing address, pho,2e and fax 9):
b) DATE OF ERECTION
7) STGN DATA
WALL. SIGNS {list size in sq. P,, illumination, type I FREE-S'i�1.1�DING SIGN
such as panel or cutout letter) _ ----
1. 1.. SIZE (in sq. ft.):
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1,E1_E ft ): I TTIPF OF M.L: TI411NATION
NOTE: A scaled realderina of each proposed siP must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
8) DATE OF DESIGN REVIEW AP'PROVAI, of applicable):
9) Applicant Signature: ��r Date:
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10, Sip-atare of Land/Building Owner: _ _ _ Date:
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Do :not write bQgrw this line
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Fee: ca'dom ejected pproved
Code (.Afficer Sic,iature. � Date: 1�16
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