HomeMy WebLinkAboutPermit Permanent Sign SN-01-49 - CHIROPRACTIC FIRSTPermit Number SN-L-'-
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, phone and fax #)
2) APPLICANT (Name, mailing address, phone and fax #) a w ".re_
3) SIGN LOCATION (include business name, address, & phone #): 02 - 6S7 - 3co
z r a,�a n u �; c i ►-s 1` 1 �f k (j
4) TAX PARCEL ID # (can be obtained at Assessor's Office
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
�oz - FrG.? z - S?(, 3 - 163aY-
7) DATE OF ERECTION ►� . _ �i�� �,, z- o c r i
81 SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter
1.
SIZE (in sq. ft. ):
2•
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft. ):
TYPE OF ILLUMINATION:
1J _ i ✓
. 5 — . u. ,, Y,. p—cu sib, must ue suonuttea uiustrating the color of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN REVIEW APPROVAL (if applicable):
10) Applicant Signature: G • /�'/d1 %�•�r• ate: ?12 7 aJ
11) Signature of Land/Building Owner: mate: / 0 e 7- 2 6b.,
eeeeeeeseeeeseeeeeeeeeeeeeaeee•eeeeeeeeeeeeeeeeeeoeeeeeaeeeeeeeeeeeeeeeeseeeee
Do not write below this line
•eeeeaeeeeeeeeeeeeeeeeeeeeeeeeeeeeee•se•eeeeeeeeeee0®eeeeAseeeeeeeseee®eeesee®
L� 4
Fee: J pplication: ❑ Rejected @'Approved
Code Officer Signature: t L� Date:
Chiropractic ; First
Family Wellness Center
Same Day Appointments
..... I ...
Dr. Michael Townsend
657-3000