HomeMy WebLinkAboutPermit Permanent Sign SN-02-45 - KINSINGTON COURTCITY OF SOUTH BURLINGTON
DEPARTMENT OF PLANNEIiO & ZONE'4G
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN-
Application for Permanent Sign Permit
P OWNER OF RECORD (Name a§ shown on deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #
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3) SIGN LOCATION (include business name, address, & phone #):
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4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
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6) DATE OF ERECTION 'SOUTH BURLINGTON, VT 05403
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
1.
SIZE (in sq. ft.): S SF '
12.
OVERALL HEIGHT: i
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION: i
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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 REVIE APPROVAL if applicable):
9) Applicant Signature: (� Date: 9 Dh �—
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10) Signature of Land/Building Owner:, Date: `I D
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Do not write below this line
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Fee: C� pli ion: ❑ R 'ected pproved
Code Officer Signature: ���� Date: / �x6,
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