HomeMy WebLinkAboutPermit Permanent Sign SN-99-44 - UVM DIALYSISOffice Copy
SIGN APPLICATION
CITY OF SOUTH BURLINGTON, VERMONT
Date 19 Permit Number
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Applicant T-7/-f K I? er Ml en VkEa-
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No. Street
(7s C-4 %- /I ri (- /&/I
Town or Cityll
Location of sign AlaLS / S I
Name of business
State
Phone No.
No. Street
r
Square footage of sign / z± Height of Sign (6
Estimated cost o)>U '—// Date of erection
Name of Erector (`C N V"1 6)
Address -ter _C �C I
nf,
11
Town or City '9tate Phone No.
Consent of Owner:
The above named person is duly authorized to make
application on my behalf. I believe the statements contained
her,qyr are true to the best of my knowledge.
9 g atur o A scant Signature og Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED APPRO Date
Reason for rejection
Issued to
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Fee Computation ° Code Officer
Date 19 �� /
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