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HomeMy WebLinkAboutPermit Permanent Sign SN-02-19 - STITCH BY STITCH ALTER.CITY OF SOUTH BU RLINGTON DEtPARTIVIIENT OF PLAI";, N <NG & ZONING 575 DORSET STREET SOUTH BURLINGTON, VERMONT 05403 (802) 846-4106 FAX (802) 846-4101 Permit Number SN- 0 9 - %� Application for Permanent Sign Permit 1) OWNER OF RECORD (Name as shown on deed mailing address _phone.and fax # z Lt)'' imp vl.t 2) APPLICANT (Name, mailing address, phone and fax #) 3) SIGN LOCATION (include business name, address, & phone It): lr _ 7 4) TAX PARCEL ID # (can be obtained at Assessor's Office 5) SIGN ERECTOR (Name, mailing address. phone and fax #): 6) DATE OF ERECTION\Pk 1 7) SIGN DATA 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. OVERALL HEIGHT: SaGNAELE WALL AREA (in sq. ft.): TYPE OF ILLUMINATION: AlyNa 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 REVIEW APPROVAL (if applicable): 9) Applicant Signature: Dcn,, e- ; �, _ Date: �A -a '2L 10) Signature of Land/Building Owner:— Date: Fee: Code Officer Signature: Do not write below this line ❑ Rejected VApproved Date: / 1 2 I -)�A S�O� �,exm-vi ayy%ls q I