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Permit Permanent Sign SN-02-43 - CHAPPELL'S FLORIST
Permit Number SN- U � - City of South Burlington', Vermont Application for Permanent Sign Permit 1) OWNER Or -FORD (Name as shown on deed, mailing address, ph ee and fax #) oa � S� K � 2) APPLICANT (Name, Mailing address, phone and fax #) L\n `� 1;:�lok OSA 3) SI6r LOCATION (include business name. address, & phone #): / L/ \\i;5 4) TAX PARCEL ID # (can be obtained at Assessor's Office) 5) SIGN ERECTOR (Name, mailing address, phone and fax #): , , „, IF-z,- 5 �� 7(-f Cam, N'�)"- ass o �" �,9tiC,\ 7g-roa� 7) DATE OF ERECTION O c�r ) S , ACYJ-2 S) SIGN DATA WALL SIGNS (list size in sq. ft., illumination, & type I FREE-STANDING SIGN such as panel or cut-out letter) 1. SIZE (in q®)� 2. OVERALL HEIGHT: A SIGNABLE WALL AREA (in sq. ft.): TYPE OF ILLUIVIINATION: .:z- NV Ih: A scaled rendenng of each proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. 9) DATE OF DESIGN 10) Applicant Signature: 11) Signature of (if applicable): r Date: vZ Date: G ®093d9�Aea®©®�DOC®®A0®9®®©t1od42 �i®®a➢060t)aim®CiA0A09�0®O®09A0A®®00909©000iO®®©®®q 0®®PIOA Do not write below this line oa®do��®o®ve®oea®ua®®®�®ae®a�ao0®®�®�aeao®®a®Boa®®e0e®0�a�o�o�®®c��®®�s►e®me®Ac��®®e Fee: A i tion: ❑ Re."ected 4-'Approved Code Officer Signature: Date: CHAPB ec 48" X 60" a S" 7.5" COPY S U✓ CHAPC 48" X 60" w 6.5" COPY ' A �CHAPA — 48" X 60" 8.75" COPY k The design above, file name CHAPA, CH_APB,CHAPC 91102 TWIN STATE is subject to the following conditions_Please read the conditions carefully and In their entirety. This drawing contains original design elements created by Twin State Signs and is subject to all copyright laws. This drawing is the property of L •� SIGNS Twin State Signs and is intended for your review and approval purposes only. It is not to be reproduced, copied or exhibited in any fashion or 4 shown to anyone outside your organization without the expressed written consent of Twin State Signs. In the event that exhibition occurs without consent, 14 Gauthier Drive Twin State Signs expects to be reimbursed $500 in compensation for time and labor entailed in creating these plans. Copyright >i2 PROOF READING Essex Junction, VT 05452 ONCE YOU HAVE SIGNED AND DATED THIS FORM, THE COPY YOU HAVE PROOF READ IS CONSIDERED FINISHED AND READY T 802-8 /2-8949 FOR PRODUCTION. ONCE THIS FORM IS RETURNED TO US SIGNED, WE ARE RELIEVED OF ALL RESPONSIBILITY FOR ANY fax 802-878-0200 Date--------- ----------- ERRORS THAT MAY BE DISCOVERED AT ANY TIME IN THE FUTURE. Acceptance or conditions_________________________________________________________________ e—mail twinsign@together.net