HomeMy WebLinkAboutPermit Permanent Sign SN-01-53 - BOURNE'Sary of SOUTH BURLINGTON
DEPARTMENT OF PIL ANNING & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN-_-
Application for Permanent Sign. Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
2)�ICANT (Name, mailing address, phone and fax e, 0 0ew'v ?,
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3) SIGN LOCATION (include bu}pess nam addres , & phone #): o eh� rl ra, e
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mailing address, phone and fax #):�jC
6) DATE OF ERECTION.
7) SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
such as panel or cut-out letter
FREE-STANDING SIGN
1. i /
3 = 7 :�
E (in sq. ft.):
2.
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OVERALL HEIGHT:
SIGNA-BI,P WALL AREA (in sq. ft.):
TYPE OF ILLUMINATION:
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 DESIGN REVIEW APPROVAL (if applicable):
9) Applicant Signature: - bate:
10) Signature of Land/Building Owner Date: ,/
Do not write below this line
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