HomeMy WebLinkAboutPermit Permanent Sign SN-01-44 - CLAY'S1)
CITE' OF SO U M BURLINGTON
DEPART.INT OF PLANNING & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERYIONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN--
Application for Permanent Sign Permit
OF RECORD (,lame as shown on deed, mailing address, phone and fax #)
/-�.cL
2) APPLICANT (Name, mailing address, phone and fax #)�---
`.Ss
971 .3zzi
3) SIGN LOCATION (include business name, address, & phone #): 97
11,a VS .61 G1! u,e.v�E _G' 41 z / 3 5_3
4) TAX PARCEL ID # (can be obtained at Assessor's Office)
5) SIGN ERECTOR (Name, mail]
address, phone and fax #):
//D `/ -2,& .o `
R io--)- 2-03 t> 7 Z-,9X 8oa -,91D3 - 0367
6) DATE OF ERECTION
7) SIGN DATA
WALL SIGNS (list size in sq. t., illumination, & type
FREE-STANDING SIGN
such as panel or cut-out letter
1. L
SIZE (in sq. ft. ):
12.
+OVERALL HEIGHT:
i
SIGNABLE WALL AREA (in sq. ft.):
TYPE OF E.LUNHNATION:
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 P - VAL (if applicable):
9) Applicant Signature: ' �l� Date: f1flo
,Dr10)
Signature of Land/Building Owner: X . 7,^- Date: SY 9 D
••eeeeeeeeeeeooeweesweeseeeeeseeeeoweeeoeeeeeeeeeeeeeeeeeseeeeeeeeesoeeesoeeeeeeoeeeeeeee• eeeeeeeeee
Do not write below this line
•eeeeeseeeeeeee`e• wlicon:
eeseeeeeeeeeseeeeeeeeeee• eeeeeeeeeeeeeeFee: ) atiO.�ejected Z,,Approved
� Date: D
a/
20% 5/8"
Proposal for signage.
Clay's Shelburne Rd., South Burlington, VT
96'-11lb
CLAYS