HomeMy WebLinkAboutPermit Permanent Sign SN-98-12 - COSMOS DINERSIGN APPLICATION
Office Copy
CITY OF SOUTH BURLINGTON, VERMONT
Date 19 Q_
Applicant �S�1DS (me-
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No. Street
Town or Cit,-
Location of sign &-s,-S
Permit Number ` L
nu- f
State
"?,; N4a-V--- NO
2 - F77
Phone No.
She (6./at
Name of business No. Street
Square footage of sign �5c% �N� /6 5 f Height of Sign 716014MJJZ
Estimated cost 51,5(60 Date of erection '(Q
Name of Erector <221e�AJV,41,'S J+�s
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66o-7-O7�4i�
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to j� Address �� _�
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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
herein re true to the beat of my knowledge.
Signature of Applicant Signature of Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED
Reason for rejection
Issued to
APPROVED Date
CR
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Fee Computation U Code Officer
Date �%,? 19
30
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