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SIGN APPLICATION
CITY OF SOUTH BURLINGTON, VERMONT
Date —ILL . 1 S ,�� Permit Number
Applicant z2le, �v'? i f� Lam' Q
No. Street
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Town or Cit State Phone No.
Location of sign GfZ- LU-e/% /9 S 1T," " 4
Name of business No. Street
Square footage of sign Height of Sign
Estimated cost Date of erection 2Z /
Name of Erector
a ress
( /I
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 contai ed
her true,to the beat of my knowledge.
ignature of,/Applicant Signature of Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED
APPROVED Date _
Reason for rejection
i
Issued to
o
Fee Computation Code Officer
9 Date `L�_
No Text