HomeMy WebLinkAboutPermit Permanent Sign SN-99-16 - 120 KIMBALLOffice Copy
SIGN APPLICATION
CITY OF SOUTH SURLINGTON, VERMONT
Date ` 19 Permit Number C '
Applicant
No. Street
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Town or City i State Phone No.
Location of sign
Square footage of
Estimated cost
Name of business No. Street
sign I Height of Sign S �i
Date of erection
Name of Erector 71 )!-:� - Z)I
Town or City
Consent of Owner:
The above name
application on my b
herein are ue he
Si na ure of Applicant
Address
State
d person is duly
if. I believe the
best of my knowledge.
Phone No.
authorized to make
statements contained
Signature of Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED OVED Date —4L� J
Reason for rejection
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Issued to �?(�_
C)
Fee Computation Code Officer G
Date 19 1