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SIGN APPLICATION
CITY OF SOUTH BURLINGTON, VERMONT
Date 0J 19 `j �/ Permit Number
Applicant S -4- - ,�,yAyt. n SPEEDY SIGN-A-RAMA
>073 WILLISTON RD
S: BURLINGTON VT 05413
No. Street TEL: 802-863-6233
FAX: 802-863-6324
Town o
Location of sign
r City
State
U;
Phone No.
Name ' of business No. Street`
Square footage of sign Heisht of Sign �!� L �� \)Qo
Estimated cost (ib Date of erection
Name of Erector
1,411 ✓L 1
Address
Town or City State Phone No.
Consent of Owner:
The above
application on
he are, true
named person is duly authorized to make
my behalf. I believe the statements contained
to the best of my knowledge.
Signature of Applicant Sinattire of Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED APPROVED DateZf� 7'
Reason for rejection
Issued to L/C
Fee Computation Code Officer
Date i 19
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