HomeMy WebLinkAboutPermit Permanent Sign SN-02-03 - S D IRELANDCITY OF SOUTH BU R,LI GTON
DEPARTMENT OF PLANNING & Z®Ip E`4G
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN--
Application for permanent Sign Permit
1) OWNTR
2) APPLICANT (Name, mail
3) SIGN
(include business name, address, & phone #):
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) 1 V U ,y .3 061
5) SIGN ERECTOR (Name, mailing address, hone Zp�dfax #):
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6) DATE OF ERECTION
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illuminaiion, & type
FREE-STANDING SIGN
such as panel or cut-out letter
1.
SIZE (in sq. ft.):
2.
OVERALL HEIGHT: �r
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SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
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
9) Applicant Signature:
10) Signature of Land/Building
(if applicable):
Do not write below this line
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Date:
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Fee: S A lication: ❑ 'ected I�Approved -
Code Officer Signature: � Date: f D
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