HomeMy WebLinkAboutPermit Permanent Sign SN-97-32 - LIFETIME WEIGHT LOSSOffice Copy
SIGN APPLICATION
CITY OF SOUTH BURLINGTON, VERMONT
Date R41 �l 19 Permit Number
Applicant A�-
r �cke f
No. Street
Avila;
Town or Ci
Location of sign
LL �17-
Phone No.
Name of b
u
siness / No. Street
Square footage of sign �c �— Height of Sign
Estimated cost ��2 S6 oil Date of erection
Name of Erector U q&tt a ✓
Town or City
Consent of Owner:
0 f 0-
State
Address
State Phone No.
The above named person is duly
application on my behalf. I believe the
h ein are true to the best of my knowledge.
S' nature of A plicant Signature of Owner
authorized to make
statements contained
DO NOT WRITE BELOW THIS LINE
Application: RWECTED APPROVED Date
Reason for rejection
Issued to
Fee Computation` Code Officer
Date -�` �� 19
ll-.� II.N.,
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