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Permit Permanent Sign SN-02-41 - CENTERPOINT SCHOOL
CITE OF SOUTH BURLD"T�C-t`' ODJ IIDEPARTMErv^a "t3 IPLAI',+jvlll` G & ZONING 575 DORSET STREET SOUT,4 B URLINGTON, VERMONT 05403 (802) 846-4106 FAX (802) 846-4101 Application Permit Number SIT- `; •; -Y/ P.vmanent Sign Permit 1) OWNER OF RECORD (Narne as shown on deed, mailing addr phone aad fax #) 2) APPLICA T (Name, mailing address', phon-e and fax #) � _ � ,-. _iL � l CL' S e—L�'it' �^ ._�L^'►{'� _ �. — - U l�-ti H �1 �✓n - � mil%%--- i .,..� ,��- 7i � % e� __ ZJ y 3) siCsN LOCATION (include business name, address> & phone #). 2....-�_ it /n 4) TAX PARCEL ID # (can be obtained at Assessor's Office) gifi--l�l�� — S) SIGN ERECTOR (Name, mailing address, 6) DATE OF ERECTION RMiN DATA WALL SIGNS (list size in sq. ft_.. illumination, & type such as panel or cut-out letter) I . -?Icsg - '/ i�� --) -- 2. SIGNABLE WAI 1� IM -'16 / � (in 9 r.� --- N'OTE- A scaled rcndciii of cat noting the dimensions of each sign. one and fax 4): -sue 4+� 4,4--'� FREE-STANDIN(U SHIN SIZE (in sq. ft- ): 0 TYPE OF ILLUMINATION: si8n nnuat be submitted illustrating the. rninr of the sign and 8) DATE OF DESIGN REVIEW jkPPROVAL (if applicable): __________ rant Signature: . 9) Applicant � �Z6 � .w. - _ 'Date: 10 Sl ture of Lana�13ui1distg Owner, � .....�.�.4....�.........e..d.a�..� VI �na OQi �.sa•JOO®06aCaO.aSiDa9Yi.00i0000000.�1YOO.b09uiD0©Ori00JOO.YOYO�Oi�O Do not write l7e1ow this line Jaos�ao.�amuJ�sar.euao�..00ua.aaeo+�m000y+roo.....oeoaao.cs.•nwo.o�oos..00m.noJease.e.w0• nrOVedJJoaawo. Fee: �� ' f ication: /R.ejected Cede Offcer Signature: Z- Ge iT%terpont S choo/ creating a safe community that promotes respect, growth and success q, �t. Centerpoint 4. �. Adolescent s . i. Treatment Services Meeting the mental health, substance abuse, and special education needs of teens and their families. I I� 1025 Airport DriveLj�-� - 73e`Y 3 C