HomeMy WebLinkAboutPermit Permanent Sign SN-98-48 - RUSHFORD FAMILY PRACTICEOffice Copy
SIGN APPLICATION
CITY OF SOUTH BURLINGTON, VERMONT
Date 19 c3 Permit Number
Applicant E�CS . ,TtA I ATLI -CL.J QAS�
No. Street
SD . u > >J U ( o5qb3 r 2 3G1
Town or City Stater Phone No.
Location of sign��s� IYY�� G�'f b. C�� �Y1
Name of business No. Street /--� a05
Square footage of sign i� 3 Height of Sign l0-(-f (�)
Estimated cost Date of erection q
Name of Erector
Address
Town or City State Phone No.
Consent of Owner:
The above named person is duly authorised to make
application on my behalf. I believe the statements contained
herein are true to the best of my knowledge.
ature of Applicant Signature of Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED APPRO� Date
Reason for rejection
Issued to
2$ 0 v / ?
Fee Computation � Code Officers
Date / / 19