HomeMy WebLinkAboutPermit Permanent Sign SN-18-56 - DORSET ST DERMATOLOGYC
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Permit Number SN-
City of South Burlington, Vermont
Application for- Permanent Sign Permit
1) OWNER OF RECORD(Name as shown of y deed, mailing address, phone and fax #)
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2) APPLICANT (Name, mailing address, phone and fax #) /t'� �el��� 5c�rcJ���
3) SIGN VO4�ATION (include business name, address, & phone #): Doc�'i ,- 54r&-&-+
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4) TAX PARCEL ID # (can be obtained at Assessor's Office) 0,50 —00 3 7a C.
S) SIGN ERECTOR (Name, mailing address, phone and fax #): - 5 Y . ��` 3e
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7) DATE OF ERECTION t b0O,
Rl SIGN DATA
WALL SIGNS (list size in sq. ft., illumination, & typeFREE-STANDINGSIGN
such alpanel or cut-out letter
1. 36 ''k �9h x5 te" 3. 5 ,GVq �".h .�, n4D SIZE (in sq. ft.):
2.
OVERALL HEIGHT: i
I
_
SIGNABLE WALL AREA (in sq. ft.):
` TYPE OF ILLUMINATION:
NOTE: A scaled rendering of each proposed sign must be submitted illustrating the color or the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN REVIEW
10) Applicant Signature:
11) Signature of Land/Building
AL (if applicable): _
Date: 1612 -7
Date: In �-I g
Do not write below this line
Fee: Application: Rejected ❑ Approved
Code Officer Signature: ` j ` Date: I kW
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