HomeMy WebLinkAboutPermit Permanent Sign SN-02-58 - MIDASCITY OF SOUTH ►BURLINGTON
DEPARTMENT OF PLANNING & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
TU
Permit Number SN-&- S
Application for Permanent Sign Permit
as shown on deed, mailing address, phone and fax #)
2) APPLICA (Name, mailin,�addres , 1}o2and fax #
3 SIGN LWATION (include business name, address, & phone #): �11, �� of /91De-,
Aef 49e-1�C--
4) TAX PARCEL ID # (can be obtained at Assessor's Office)11K - 6 O d 6D
.5) SIGN ERECTOR (Name, mailing address, phone and fax #):
6) DATE OF ERECTION
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter
I
SIZE (in sq. ft.):
2•
OVERALL HEIGHT:
SIGI 1_ r WALL AREA (In sq. ft.):
TYPE OF ILLUMINATION:
iw r n: H scaiea renaenng or each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign"
8) DATE OF DESIGN REVIEW AP P OVAL (if applicable):
9) Applicant Signature. Date:
10) Signature of Land/Building Date: // ! / 0/0 Z
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Do not write (below this line
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Fee:_ — lication: ZRe,,d Approved
Cede Officer Signature: Date:
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