HomeMy WebLinkAboutPermit Permanent Sign SN-97-68 - VT. GIFT BARNSIGN APPLICATION
A1q# F a Copy
Date
Applicant
CITY OF SOUTH BURLINGTON, VERMONT
19
LL.O
N o . St t GrT
Permit Number
Town or Ci y state Phone No.
Location of sign
Name of business No. Street
�wQZ�
Square footage of sign �Z�� Height of sign
Estimated cost � � � � Date of erection
Name of Erector
Town or City
Consent of Owner:
Address
State
The above named person is duly
application on my behalf. I believe the
herein are true to the beat of my knowledge,
i
signet _- -.. nk0JV L%:CWA•� signature of Owner
Phone No.
authorized to make
statements contained
DO NOT WRITE BELOW THIS LINE
Application: REJECTED APPROVED Date ! ��
Reason for rejection 'v~
Issued to
Fee Computation
/ dO
`
Code Officer
Date
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