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HomeMy WebLinkAboutPermit Permanent Sign SN-03-32 - CELLULAR ONECITY OF SOUTH BURLIN, GTOIN DEPARTMENT OF PLA1*dNEiG & ZONLNG 575 DORSET STREET SOUTH Bu'iZLIi 1GTON, VERTMOTN7 05403 (802) 846-4106 FAX (802) 846-4101 Permit Number SN- 6 ) - .) Application for Permanent Sign Permit 1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #) ., AjitNt Ni- .CC�✓Y1 /1 2) APPLICANT (Name, mailing address, phone and fax #) �-e Il a I -�-- Al %%l Pan,c-1 vzr i--e- v a -zZ s� 3) SIGN LOCATIO (include busmes��,acdlddrp & phone #): _ 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 5) STGN ERECTOR (Name, mailing address, phone and fax #): 6) DATE OF ERECTION I In - 7) STGN DATA ( J, VA � L F WALL SIGNS (list size in sq. ft., illumination, & type FREE-STANDING SIGN such as panel or cut-out letter) 1. SIZE (in sq. ft.): N) CSK S�V-1 Y VA -e— 2. OVERALL HEIG -.+ SIGNABLE WALL AREA (in sq. TYPE OF � RUMINATION: C . NOTE: A scaled rendering of each roposed sign must be submitted illustrattng the color of the sign and noting the dimensions of each sign. Cr 8) DATE OF DESIGN RE PROVAL (if applicable): .l ! 9) Applicant Signature: Bate ICE J 0-3 10) Signature ofLand/Building Owner: Date: G •eeeeeeeeeeeeeeeeeeeeeeeeeeeeaeeseeeeeaeeeeeeeee�eeeeeeeeeeeeo•eeo•eaoeseeewoeeeieeeeeeeeeeeeeeeeeeeee Do not write below this line •eeweseeaeeweeee• eeeeeeeeeoeaeeaeeweaee�eeeseeeeeeseeeeeweseeeseeeeeeesoeeeeeoeee• •oeeeeseweeeoeeee•proved Fee: Zs- ation: El Rejected Ap i Cede Officer Signature: kL Date: �L�