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Permit Permanent Sign SN-02-53 - NORTHERN MERIDIAN
CITY OF SOUTH BUIRLINGTOINT DEPPAE.TME1`7 OF PLANNING &A ZOI'1D\IG 575 DORSET STREET SOUTH D1 13LINGTOIN, VEEMOr-iT 05403 (802) 846-4106 FAX (802) 846-4101 Permit Number SN- -31 -5 Application for Permanent Sign Permit 1) OWNTR OF RECORD (Name as shown on deed, mailing address, phone and fax #) 1-770 -/ % SoyTH (✓t �0� L T . �G l T �% ZZ-C ZLA-14-- �- 2) APPLICANT (Nanne, mailing address, phone and fax #) /V E 3) SIGN LOCATION (include business name, address, & phone #): �2� im.� 1ci�n/ ftcn,p�� SaJr;4� a4,fv-1n,6TG.1) vT 6cU 1' J G�-Yso? 4) TAX PARCEL ID # (can be obtained at Assessor's Office) /o3-c, -cn 3-zs-- t 5) STGN ERECTOR (Name, mailing address, phone and fax #): 1 =.al rt.vv!J rG�— z� / O - .3 i P Svll e`- L 2-e'J _rJhyT GSA/_��-iS 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) S\.J/j Ori A t fk/z>✓F c4v SITE -0.1-6 �- l. SIZE (in sq. ft.): i'X" 2. OVERALL UEIGF r � off.. �i�G-E s:.�.Ln — Feel - SIGN -ABLE WALL AREA (in sq. ft.): I TYPE OF ILLUMIrTATION: -t NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. (5- -Z- 4-74,fu416 p '7— 8) §ATE OF DE&WiN-REVIEW APPROVAL (if applicable): /p/ I Iu-- - LL1 ® c_' ✓1 ✓� 1ti/aTc � fir' N 91plicant Signature: �'�--� 1�—�� Tate: S ,4vE'/oZ Cn 10 ignature of Land/Building Owner,,� ,,rDate: � ee®®®9.aeo®©o®eet�egoo®�eu9�®®aoao©eaooeaeeo®uoog®�s�0000000�a�aeeo®o®tloa�aea®aro®on®c�®aoem�a®oo�ee®eam®mse )uj Do not write below this line :3dt4g�+a�:4*�P.tS®?®9c�6tsaEm9t1�i t9iA%�:itltl9®tl:dA9A6tlP_29099.Dtl3�:'�+d.990A5®Ntl9Ltld8tl904©ff9tltltl6A0Yale®A@D®Y90M06i®��n906!!Q Fee: cS,, CD A13;plication: ❑ Rejected >Approved Code Officer Signature: � Date: 6U UL-0 i b 8LA -STO i