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HomeMy WebLinkAboutPermit Permanent Sign SN-03-28 - COCONUTSCITY OF SOUTH 1BURLINGTO DEPARTMENT OF PLANNING 1a0z; ZO)1TDTG 575 DORSET STREET SOL7H BURLINGTON, VERMONT 05403 (802) 846-4106 FAX (802) 846-4101 Permit Number SN--6"2- Application for Permanent Sign Permit 1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #) o 2) APPLICANT (1\(ame, mailing address, phone and fax #} Tw•h See-�. S� v�.S lti c .V-.:Q.c Oc. sSou rt-��..; \-r os—kS'� C9 ) ccIZ-Y9 44 Tt3Z - P7S-- Z. 3) SIGN LOCATION (include business name, address, &hone *): p 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 5) STGN ERECTOR (Name, mailing address; phone and fax it): CS � �► � s �� ..,�' 6) DATE OF ERECTION. 7) STGN DATA 6/ y-�3— WALL SIGNS (list size in sq. ft., illumination, & type such as panel or cut-out letter) FREE-STANDING SIGN 1. SIZE (in sq. ft.): 2. I OVERALL HEIGHT: SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLU-NI NATION: MOTE: 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 APPROVAL (if applicable): 9) Applicant Signature: f 0) Signature of Land/Building Owner: {{Yoa9�lJ®Oeai000®d00Hm0960N0{00{O{OAe{Q{0{G{{ONJ9090e000{00�� (�4 66e{e®0ee0{e4e0 Do not write belo s line ass•seseaee�eoseeyaggwoeaseaaeo�eaoaeee{ee{s{{{{as{ea{{a• {{oe{e{{{sss{e{ese Fee: A cation: 11] Re'ected Code Officer Signature: 9' . Date: bJ Date: eoeeeowcae{000e{{.aoo{oa®4.� {{1{J JNd+BeOMO�l.eproved Date: Z G1 6.1c.0 T f `t — k L ':� y 10, LD rl► Pau a This drawing contains orlginal design elements created by Twin Stale Signs and is sukier.i Is all copyright laws. This drawing is the property of Twin Stale Signs and Is Intended ter your review and approval purposes only. It Is not to be reproduced, copled or exhibited In any fashion or shown 10 anyone outside your organization without the expressed written consent of Twin State Signs. In the event that exhibition occurs without consent, Twin Slate Signs expects to be reimbursed $511 In compensation for time and labor enlalled In creating these plans. Copyright • PROOF READING ONCE YOU HAVE SIGNED AND DATED THIS FORM, THE COPY YOU HAVE PROOF READ IS CONSIDERED FINISHED AND READY FOR PRODUCTION. ONCE THIS FORM IS RETURNED TO US SIGNED, WE ARE RELIEVED OF ALL RESPONSIBILITY FOR ANY ERRORS THAT MAY BE DISCOVERQAT ANY TIME IN THE FUTURE. Accoptan.. i Conditions -----__-.-- _- ,- ---___--- _ _ IL�Ie _ -- -- .------- SpecificalioitS DaIe Client Mile Name Design by Twin Stag Signs 14 Gauthier Drive F.scex .10., VI' 05452 802- -8949 907-87h 1121111 I aX