HomeMy WebLinkAboutPermit Permanent Sign SN-01-73 - JOLLEYCITY OF SOUTH BURLINGTON
DEPARTMENT OF PLANNING & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802)846-4106
FAX (802) 846-4101
Permit Number SN- 0 -�
Application for Permanent Sign Permit
1) OWNER OF RECORD (Nance as shown on deed, mailing address, hone and fax #)
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2) APPLICANT {Name, mailing address, phone and fax #)
3) SIGN LOCATION (include businessparne address, & phone #): J 2y
\1 tO S1.��4,. 2(3• Suzy SZ%- v ( *
4) TAX PARCEL ID # (can be obtained at Assessor's Office) S 1 S`(� �' l l u • L
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
5, 3�CIIP-o. 13 -X (07t ST- 0 t� 5
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6) DATE OF ERECTION 2 Uy Z
71 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, &type
FREE-STANDING SIGN .
such as panel or cut-out letter)
1" t of'l , 'TA �- Qr\ � S r
SIZE (in sq. ft. ): Z
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2. cam+ wk t �<<s Z,
OVERALL HEIGHT:
SIGNABU WALL AREA (in sq. ft.): 1 exckq
TYPE OF IL
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1LUMINATION:
1ker J
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 DES VIEW R z
licable):
9) Applicant Signature- ate: % t
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10) Signature of Land/Building Owner: Date:
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Do not write below this line
waweeeeweeeeao oeoaeaeeeoeeeeeereeeeooaeeesepwoeeaeee+sseweeeeeewesseeoee+we•edaaoewe00000eses
Fee: placation: ❑Rejected se Approved
Code Officer Signature: �� Date:
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