HomeMy WebLinkAboutPermit Permanent Sign SN-01-37 - VT AIR NATIONAL GUARDCITY OF SOUTH BURLI NL GT ON
DEpARrj'?+ jENT OF pIANj%,TING & ZONING
575 DORSET STREET
SOUTH BURLINGTON, VERMONT 05403
(802) 846-4106
FAX (802) 846.4101
Number SN- -_ ___--[---
Pen -nit 0 u L
Application for Permanent Sign Permit
1) OWNER OF RECORD (Name as shown on deed, mailing address, plane and fax #)
2) APPLiCAN7 (Name, n-#ling address,yhonp and fax #)14=J- '.51aY%i
3) SI N LO ATION (include bu mess ame, address, & phone #): l�l��1� Ir
4) TAX PARCEL ID # (can be obtained at Assessor's Office)-
5 ISIGN ERJECTOR (1�am mailing address, phone and fax #):
> f r e /-i" !) Lam/ J/
b) DATE OF ERECTION
NOTE: A scaled rendenng or eacn piupuscu „t6i, .r— ���.------ -- - -
noting the dimensions of each sign.
8) DATE OF DESIGN MI
9) Applicant Signature
10) Signature of Land/Building Owner.
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Fee:
Code Officer Signature:
: ❑
(if appli able):
Date: k / v l
Date:
Date: � /A/,C)
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