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Sicn C.+ner (i{LOU INC
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,ddress
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ate �,dy name Cf r-
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Mane cs Licensed Sicn =rector Salem
�� neLy MA /G//C_ License Ito. z3L
;ddress (Z3 ��z1 1 /,E_Vef
- flocr ✓ 3rd-Floor
Jse Of Buiidinc: S . 4r Floor
end Floor
-YPe Of Sian: Bursate.
Right Angles to cuildinc , Free Standing ,
_ Other (specify) Height:
Sicn daterials. n ASr1C {
Sicn �inensians
�I x 28q (2 SI(vNS Sian Area 56 Eh C-11 SF
Sign Area ' �i � SF
Existing Signs : Surface: Sign Area Sf
Richt Angles : Sian AreaSF
Free-Standing Sian Area SF
Other
Sion Area SF
Signs to be Removed: Type FT
l x �5 FT Property
Frontage: Building
ture of Owner
a.1d Address of Signa
Insurance Company
LSignature of CN+Hers Authorized Representative
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g3 PReKFN<5T RII CfWM5�QI�.MA Address 11 �'l�tflZGlf STI S a-Mq
Estirated CostJ�/6 �� Telephone
of New Work�—
Signature of Property Owner
APPROVAII,( AG�� r=pz OuJ�,Sc�
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