HomeMy WebLinkAboutPermit Permanent Sign SN-95-17 - LIBERTY MUTUALOffice Copy
SIGN APPLICATION
CITY OF SOUTH BURLINGTON, VERMONT
Date ,t`%fi�� 19 Permit Number /
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Applicant S!%�w �.r C/�b�!/i �'' % AZI 1
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No. Street
Town oV City Y State Phone No.
Location of sign �. ,`% / /0, ww// Yu,11yil�
Name of business No. Street
Square footage of sign u!rr r Height of Sign •'r
Estimated cost A Date of erection
Name of Erector <`; F' '' "' v <-
Address
Town or City State
Consent of Owner:
Phone No.
The above named person is duly authorized to make
application on my behalf. I believe the statements contained
he ein are true to the best of my knowledge.
/ •i ny __
Si#ature of Aliplicant Signature of Owner
DO NOT WRITE BELOW THIS LINE
Application: REJECTED CPPROV Date
Reason for rejection
Issued to
to ✓`� -� �' `
Fee Computation �G-' Code Officer Y
Date
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This plan and all arrangements shown on it are the sole property
of Design Signs. Any form of reproduction of this plan in whole or in
part is prohibited. This plan is not to be used for the construction of
DATE
any design without first obtaining written permission from Design
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Signs.
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