HomeMy WebLinkAboutPermit Permanent Sign SN-01-76 - CLAY'S1)
CITY OF SOUTH BURLINGTON
DEPARTMENT OF PLANNING & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN-o/ -�
Application for Permanent Sign Permit
OF RECORD (Nance as shown on deed, mailing address, phone and fax #)
b'o �- 86 3 i� R � x a-o S 3 ;k-1(v Z
2) APPLICANT (Name, mailing address, phone and fax #)
/ E-er r� 3 1kwAa S
7 ei o a/ >- a `A ,C Rv R? 3- 7- i t
3) SIGN LOCATION (include business name, address, & phone #):
/,.7 �L ,S /So 0d,'_-SE t S' So �c 3 79 0� /� X - V
4) TAX PARCEL ID # (can be obtained at Assessor's Office) Ds"7 o -- o oiSv, Cao3
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
eSo z- 2-2-2 D 3 s' 7 a- 2 1- 3 v 3 67
6) DATE OF ERECTION /V r*— - 1�e_ / IF
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter)
/t-,, uc.Q
1.
SIZE (in sq. ft.):
1 � &U
yW
2.
OVERALL HEIGHT:
SIGNTABLE Az7AL L AREA (in sq. I?.):
I� TYPE OF I,L�JLT�IATI
NOTE: A scaled rendering of 4%a[i proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
8) DATE OF DESIGN
9) Applicant Signature:
10) Signature of Land/Building Owner:
AL (if applicable): q ) Sj7d
Date: T��6
Qsf r - v SSo C/A
? v' Ili, -I_ Date: /4 n f
Do not write below this line
•�����������s�����e���r�����ss������s��••�����o�a���������s����sss������es�������s• •................
Fee: plication: D ected Approved
Code Officer Signature: Date:
Ll
o/
I