HomeMy WebLinkAboutPermit Permanent Sign SN-02-48 - PILLSBURY MANORCITY OF SOUTH BURLINGTON
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575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN- U 9�--t=;---
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
2) APPLICANT (Narne, mailing address, phone and fax #) 5'b(kV'
3) S GN LOCATION (include busin ss na e, address, & phone #):
4) TAX PARCEL ID # (can be obtained at Assessor's Office) _
5) SIGNN E1RECOR (Name, mailing address.hon and fax
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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
1.
Izl� (in sc. 4. ): /
'
/ S
2.
OVERALL HEIGHT: /
-
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 sib and
noting the dimensions of each sign.
S) DATE OF DESIGN REVIEW APPROV_U (if applicable):
91 Anniicant Signature:
10) Signature of Land/BuildingOwner:
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Fee: 1 W
Code Officer Signature:
Do not Orite below this line
Date:
Date:
�pproved
ected
Date:
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