HomeMy WebLinkAboutPermit Permanent Sign SN-99-32 - GET WELLSIGN APPLICATION
Office Copy
CITY OF SOUTH BURLINGTON, VERMONT
Date 19
Permit Number
Applicant (: P_- WC 1
Od(3 ��r �tS��► h 1� Oct Is
No. Street
Town or
Location of sign
15 t,�� 1�J1 rt
Square footage of
L-) u t- ( I Gl 1 AO s U =n / /V
City State Phone No.
Name of business No. Street
signLDS
Height of Sign qZ" Ceainc 123,"
Estimated cost i UC) -- Date of erection �uj4 � 5
Name of Erector VAV`Sk1' VV-
_ I�c�� �[►� h AVdress
Town or City State Phone No.
Consent of Owner:
The above named person is duly authorized to make
application on my behalf. I believe the statements contained
her i-v are tr a to. toe best of my know d
Signatur o A icant Signature of Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED
Reason for rejection
Issued to
r U�
Fee Computation �_ Code Officer
Date 19
Date
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