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Permit Permanent Sign SN-01-66 - MCSOLEY MCCOY & CO
Permit Number SN- 0 - City of South Burlington, Vermont Application for Permanent Sign Permit 1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #) /Z 0 /yI��LG �� �; �o �s'o k gL y - /ZZ �; "I'ce Z P Z -Y�zZ 70Z4 2) APPLICANT (Name, mailing address, phone and fax # C��flGA) f `c�A) s C GG 6 0.Z' S 3) SIGN LOCATION (include business name, address, & phone ACIO y Ca , //o /6R%G� Z1/,E 6 s�- /80S 4) TAX PARCEL ID # (can be obtained at Assessor's Office 5) SIGN ERECTOR (Name, mailing address, phone and fax #): 7) DATE OF ERECTION (, Z 6 d / 8 SIGN DATA WALL SIGNS (list size in sq. ft., illumination, & type'FREE-STANDING SIGN, such as panel or cut-out letter 1. ye - -F 0 (b - 0'1> -9/- 010'11V6f&i S (i sq: ft.): /-ET12F�f—*2, z ZD.ZS� 2. /1/a I;z-L C11A/N,f ?lra./ OVE L IG SIGNABLE WALL AREA in sq. ft.): TYPE O L A N: Nviv A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and noting the dimensions of each sign. 9) DATE OF DESIGN RE W APPROVAL (if applicable): 10) Applicant Signature: Date: �l z - 11) Signature of Lan ing Owner: Date: \ l saeeesose.•soeeoeeeoeeoeeoeseseeeeeeeeeoeseooeseesoeesooeeeooeeeeoeeessee••see Do not write below this line 000.•ooseeeeesee000ssaeoseeeosseeee•eeeseesesseeooeseesoeeweoeseeooeeeeeeeeeo• Fee: App*cation: ❑ R *cted Approved Code Officer Signature: Date: �` �� k f j I � I rt I� I El 1 aient - D MC fQl'Ef MC C4 K CO I N C O R P O R A T E D Drawing Number Date Scale y/zi I0-1-01 tN �tr PO Box 1048, 644 Blair Park Road, Williston, VT 05495 This design is the sde property of Design Signs, Inc. Any form of reproduction of this design in whole or in part is prohibited. voice 802-872-9906 fax 802-872-9910 This design is not to be used in any sign. print broadest or electronic designsignsvt. com media ` AJi= vATMen permission of Design Signs, Inc © 7 Q Q