HomeMy WebLinkAboutPermit Permanent Sign SN-01-39 - TEESON REAL ESTATECITY OF SOUTH BURLINGTON
DEPARTMENT OF PLANNING & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846-4101
Permit Number SN- G' I -_3
Application for Permanent Sign Permit
1) WNER OF RECORD (Na e as shown on deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #) �� (e s �.
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W T Cl yo 3 S-6 — 6 / 1 / �r a q'G L '73. '.�'
3) SIGN LOCATION (include business name, address, & phone #): 7 p
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) _
5) SIGN ERECTOR (Name, mailing address, phone and fax #):
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6) DATE OF ERECTION Jtsi z /
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7) 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.): S
2.
OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.):
TI'P OF ILLUMINATION:
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NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
S) DATE OF DESIGN REVIEW APPROVAL (if applicable): 12 o
9) Applicant Signature:/ e te �, Date:
10) Signature of Land/Building Owner:
Date:
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Do not write below this line
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Fee: , G Application: ❑ Rejected EXApprove/d
Code Officer Signature: �� �ty��t-- Date:
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