HomeMy WebLinkAboutPermit Permanent Sign SN-03-27 - BLOCKBUSTERSCITY OF SOUTH B UBLINGTI O
DEPARTMENT OF IPIAANI YI�4G & ZOI^IE\IG
575 DORSET STREET
SOL7H BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN-y`' - E --
Application for Permanent Sign Permit
1),AOWNER OF RECORD (Name as shown on deed, `mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #)
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3) SIGN LOCATION (include business name, address, & phone #):il
4) TAX PARCEL ID # (can be obtained ar Assessor's Office)
S} S1I-TN ERECTOR (Name, mailing address, phone and fax #): �S4 L•.� �s �� ..�o.�
6) DATE OF ERECTION 03
7) STGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
1. llk�lljl�_ Ana ti.l-1`
SIZE (in sq. ft.):
aa.s3
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA
A (in sq. ft.):
TYPE OF ILLIJIUIINATION:
76-0
NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and
noting the dimen+ns of each sign.
8) DATE OF DESIGN REVIEW APPROVAL (if applicable):
9) Applicant Signature:
0) Signature of Land/Building Owner: ,
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Do not write
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Fee: Lam/
_ Date:
Date:
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line /
lic Lion: ❑ ected
Approved
Code Officer Sig -nature
Date:
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This drawing contains original design elements created by Twin State Signs and is subject to all copyright laws. This drawing is the property of
Twin State Signs and is Intended for your review and approval purposes only. It Is not to be re/roduced, copied or exhibited In any fashion or
shown to anyone outside your organization without the expressed written consent of Twin State Signs, in the event that exhibition occurs wilhiut consent,
Twin Stale Signs expects to be reimbursed $581 in compensation for time and labor enlalind 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 PRODUCHON.
ONCE THIS FORM IS RETURNED TO US SIGNED, WE ARE RELIEVED OF ALL RESPONSIBILITY FOR ANY ERRORS THAT MAY BE
DISCOVERED AT ANY TIME IN THE FUTURE.
Acceplance of Condilinns .--... _..--- --.--------_-.._. _ nah ----------------------
Speci(icalions
Dale
Client
File Name
Design by:
'rwin Stitt',
Signs
14 Gauthier Drive
I",ssex JcI., VT OW2
802-872-8949
9112-879-1121111 FnN