HomeMy WebLinkAboutPermit Permanent Sign SN-95-02 - CENTER FOR CHIROPRACTICOffice Copy
ON AMICATION
CITY OF SOUTH MUNfT U,
Date 1 19 45Z� Perms Number i
Applicant' �f/:�
No _ treat
i� 7 r
'Town or City Mate Phone No.
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Name of business /// No. Street ro6l- ,d-
Square footage of sign
Pied gkt cf Sign crr
Estimated cost1�arad
Date of erection
Name of Erecter�J�C>�/l.�.f1 }
Town or /Cf tj
a •av•sc s�V •
Consent of Owner:
he "Ova named person . is duly authorized to make
app oatio on ■y alf. I bVive tho statements containeoiein a truuee t th beg of �syw3edge. ...... ... _ _ . _.._�
&kifnature of AP ica t mature: of Owner
i
DO NOT WRITS BBL OW THIS LINE
Applioetion: REJECTED � APPROVED Date
Reason for rejection
Issued to li v ,���/ /fi l
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Pee► computation# ,`� Code: Officer
Date
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Dr. Mary
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