HomeMy WebLinkAboutPermit Permanent Sign SN-94-05A - H&R BLOCKOffice Copy
CITY OF SOUTH BURLINGIM, VERMONT
SIGN APPLICATION .
1 _
Date 19��1� Permit Number
Applicant/d
i P
5
Street
le r
Town or City State Phone No.
Location of sign
Square footage of sign /y Height'of sign
Estimated cost
Date of erection
Name of Erector - A,
Address
Town or City JState Phone No.
Consent of Owner:
The above named person is duly authorized to make application on my
behalf. I believe the statements contained herein are true to the best of
my knowledge.
ignature of Applicaton--Signature of Owner
DO NOT WRITE BELOW MIS LINE
Application: REJECTEDCJ
AP Date
Reason for rejectionE�-� '
ze
Issued toW'�-�
Cemput2ltlOn' �r Code Officer
Date % �Jr 19
THE INC
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