HomeMy WebLinkAboutPermit Permanent Sign SN-18-32 - CHAMPLAIN VALLEY DISPENSARY0
Permit Number SN-It
City of South Burlington, Vermont
Application for Permanent Sign Permit
1) OWNER OF RECQRD (Name as own on deed, mailing address, hone and fax #)
EN/i1 r=_�
3)SJG,N LOCATION (include busin s name address, & phone # : llv
4) TAX PARCEL ID # (can be obtained at Assessor's Office) 07 2- 5 aooa 2-
1
S) SIGN ERF,CTO (N me, mailing address, pone and fax #):
o
7) DATE OF ERECTION- Cn f 5� _
_8) SIGN DATA _ _
WALL SIGNS (list size in sq. R., illvmination, & type FREE-STANDING SIGN _
such as panel or art -out letter)
SIZE (in sq. ft.):
2. OVERALL HEIGHT:
SIGNABLE WALL AREA (in sq. ft.): �r�o , TYPE OF ILLUMINATION:
NOT$: A scaled rendering of each proposed sign must be submitted illustrating the color of the sign and
noting the dimensions of each sign.
9) DATE OF DESIGN REVIEW APPROVAL (if applicable): _
10) Applicant Signature: - -� Date: Co-
11) Signature of Land/Building Owner: _ Date:
Do not write below this line
Fee: Application: Rej Approved
c
Code Officer Signature: Date: �� G
r
-
CHAMPLAIN
VALLEY
DISPENSARY