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HomeMy WebLinkAboutPermit Permanent Sign SN-03-33 - CELLULAR ONE1 _l OWNER CITY OF SOUTH BURLINGTON DEPARTMENT OF PLANNING & ZONING 575 DORSET STREET SOUTH BURLINGTON, VERMONT 05403 (802) 846-4106 FAX (802) 846-4101 Permit Number SN- �s E Application for Permanent Sign Permit RECORD (Name as shown on deed, mailing address, phone and fax #) 2) APPLICANT (Name, mailing address, phone and fax #) e /l a !� -2_, l L{ %%l e -e IMrXA C, ()nA/ Wi C_ /r7i 1 .n 1 2?,4,4 Yf,_� C _/_ �VU0 - 660-z2S_4. 3) SIGN LOCATIO (include busmes name, address, & phone #): 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 5) SIGN ERECTOR (Name, mailing address, phone and fax #): 6) DATE OF ERECTION I I d 7) SIGN DATA {n WALL SIGNS (list size in sq. ft., illumination, & type FREE -STAND tNG SIGN NO such as panel or cut-out letter 1. p_p SIZE (in sq. ft.): C 2• OVERALL HEIGHT: SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: 1 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 RE PROVAL (if applicable): v 9) Applicant Signature: Bate: �� Q3 &dz",10) Signature ofLand/Building Owner: � Date: � G Fee: Code Officer Signature: Do not write below this line lea VApprooved Date: (/ /C