HomeMy WebLinkAboutPermit Permanent Sign SN-02-10 - CENTER FOR CHIROPRACTICPermit Number SN- C21 - ID
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER 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 #):<di%E/Z ��
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #): �//, fx,J
7) DATE OF ERECTION_ Rl�e ill, ZO'G Z
8 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter
FREE-STANDING SIGN
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GW 4"
SIZE (in sq: ft. ): 2 0
2.
OVERALL HEIGHT: /
SIGNABLE WALL AREA (in sq. ft.)-
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TYPE OF ILLUNIINATION:
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NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN RE W APPROVAL (if applicable): 3 OZ
10) Applicant Signature: vl r C/ Date: 3 - -0 -
11) Signature of Lan ui ing Own fj,,,-,.r- ,l �c— Date: 3 - 7 0 o&'
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Do not write below this line
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Fee.-tL—Z Application: ❑ Rejected �-Approved
Code Officer Signature: Date:
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Sr 170,21
S r4M PE MO PO V 6
Design Signs, Inc.
644 Blair Park Road
PO. Box 1048
W;djistoii, VT 05495
CENTER FOR
Chiropractic
AND
Holistic
Health
Dr. Tiffany Renaud
Dr. Mary C. Spicer
Studio One
Electrolysis
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