HomeMy WebLinkAboutPermit Permanent Sign SN-02-63 - MIDAS1) OWNER
CITY OF SOUTH BURLINGTON
?DEPAR,TIV1ENT OF ;PLANNESIG & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN-
Application for Permanent Sign. Permit
(Nance as shown on deed., mailing address, phone and fax #)
3) J N LCCATI , (include business name, address, & phone
4) TAX PARCEL ID # (can be obtained at Assessor's Office)6 b 6 46-&
5) STCrN ERECTOR. (Name, mailing address, phone and fax #):
6) DATE OF ERECTION
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter
1 FREE-STANDING SIGN
(s�
SIZE (in sq. ft.):
2. /
OVE HEI T:
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUNIINATION:
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: o Date: Z---
Its) Signature of Land/Building Owner: C-7<' �' �_ Date/?-44'd Z
Do not write below this line
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Fee: �� Gf,�eation: El Rejected pproved
Cede Officer Sig:�ature: �In Date:
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