HomeMy WebLinkAboutPermit Permanent Sign SN-92-918 - STAPLESOffice Copy
CITY OF SOUTH BURLINGfMf VELtMONT
SIGN APPLICATION.
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Applicant
No. Street
Permit Number i.f
Location of sign lta o&
Name of b iness No. Street
Square footage of sign / / i3 r S� Height' of sign
Estimated cost Date of erection
Name of Erector
Address
_ ss Q�
i2ve�lf -, p 2 ?
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 oontained herein are true to the best of
• my knowl e.
Si ture f Applicator Signature of Owner
DO NOT WRITE BELOW THIS LINE
Appl ica t ion : FWBCTED APPROVED Date�-
Reason for rejection
Issued to
CIO
��Fee1.. Computation ��'--" Code Officer ���� .. �-�
Date�-