HomeMy WebLinkAboutPermit Permanent Sign SN-02-09 - URGENT CARECITY OF SOUTH BURLING` ON
DEPARTMENT OF PLANNE'4G & ZONPiC
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
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Permit Number SN- C' -
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
2) APPLICANT (Name, mailing address, phone and fax #) ko z - g6s- r 6 s 9
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3) SIGN LOCATION (include business name, address, & phone #):
l Z 3 7 S k v(6 w,._ fe./ -
4) TAX PARCEL ID # (can be obtained at Assessor's Office
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
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6) DATE OF ERECTION,d r w w. y L o 6 z.
7 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
1 'Y " X SS"
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SIZE (in sq. ft.): (, q SF
2•
OVERALL HEIGHT:
ti y
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
`L `f 8 S F (qG' x 1-7r')
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 APPROV
9) Applicant Signature:
10) Signature of Land/Building
Fee: / (."'
Code Officer Signature:,
applicable):
1 Date:_
Date:
not write belo`ov this line
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Date:
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Champlain Malley
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91LW70";A I t Awl
18" x 55" sign for entrance (part of 32 sq. ft. entrance directory) installed to height of approx 4 ft
Same size sign on building facade — Installed to height of approx 11'
l(Urgent
Care
8" x &V directional sign —
.,`Champlain Malley
Urgent Care
4 114' x 18 1/2" building directory
_champlain VaOey
Urgent Care
3" x 12" door sign
SIGN- i*��aAAM
3073 WILLISTON ROAD
SO. BURLINGTON, VT 05403
TEL: 802-863-6233
FAX: 802-863-6324
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