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SIGN APPLICATION
CITY OF SOUTH SURLINGTON 2 VERMONT
��Date ;; SOU Permit Number
Applicant _�� t�.;l -5 ��rvT 5_ Sc iL +4TLNLS
(A (-,C c----'I"� M ny 1 b4 t
No. Street
Town or CityTITS -�E/UT^ < State Phone No.
SG►2.i4TL �(= �
Location of sia n VVLVU Aj—t ).} I vy ye -
Name of business No, Street
j
Square footage of sign Height of Sign
ryJ�
Estimated cost Date of erection
Name of Erector 5i:E� LF -?3cp' �pi Sl- &K-
Address
Town or City State Phone No.
Consent of Owner:
The above named person is daily authorized to manse
application on my behalf. I believe the statements contained
herein are true to the best of ;may knowledge.
Signature of Applicant Signature of Owner
DO NOT WRITE BELOW THIS LINE
Application, REJECTED
Reason for rejection /V
Issued
b
Fee Computation S— Codt
Date
PROVED Date
a
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Bob Fisher