HomeMy WebLinkAboutARB202000033 Application 2020-02-21Application and Checklist for Sign Permit A
Part A: Applicant and Parcel Information
Project Name: Fairfield Inn and Suites Address: 577 Branchlands Blvd
Tax map And parcel(s): 061 ZM3-00-011 CO
Zoning:
Contact (Who should we call w/ questions?) Name: Peter Gropper
Business Name: Atlantic Coast Signs & Elec
Address PO Sax 243 city Ruckersville
state VA zip 22968
Daytime Phone ( 434) 979-7275 Fa[434) 985-1960
Email atiantccoastsigns@msn.com
Contractor Name: Peter Gropper Business Name: Atlantic Coast Signs & Electric
Address PO Box 243 City Ruckersville
State VA zip 22968
Daytime Phone (434) 979-7275 Fax # { 434} 985-1960
E-mail atlanticcaastsigns@msn.com
Business Owner Name: FF Chalottesville North Inc Business Name:
Address 5920 South Miami Blvd, Suite 102 City Morrisville
state NC zip 27560
Daytime Phone L_) Fax # (-__--_ j
E-mail
Part B: Determining application requirements and fees
1.
Sign Permit — Please indicate which sign type you am applying for:
®
Freestanding or Monument Sign:
$91.64
❑
If a footing is required, an additional fee is required:
$32.64
Wall Sign (Including property, awning, fuel pump canopy signs):
$91.64
❑
Sign Refacing:
$59.00
2.
Electrical Permit — Will the sign be illuminated?
m
Yes (Illuminated signs require an electrical permit and an electrical schematic)
$48.96
❑
No
$ 0.00
3.
ARB Review — 91111 the permanent sign(s) be constructed in an Entrance Corridor?
(Go to www.albemarle.orglarb for more information.)
Yes ('Chis sign will be constructed in an Entrance Corridor and it does not meet the criteria ofan
$129.00
approved Comprehensive Sign Plan. See ARB requirements next pages.)
Cl
Yes (This sign will be constructed in an Entrance Corridor and it does meet the criteria of a
Waive Fee
Comprehensive Sign Plan (CSP). Write the name of the CSP here.
See ARB requirements next pages. For more info on CSPs, go to the link at www. albemarle.orglarb
❑
No (This sign will not be constructed in an Entrance Corridor)
$ 0.00
FEE TOTAL (Please add all the amounts checked in sections 1— 3):
$
Y
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Fee Amount $ I Date Paid who? Rese�pt #G 5� ec # ks~ By
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County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fag: (434) 9724126
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SECTION 4: WORK VALUATION
A. Work Valuation $ 3800.00
Part D: Applicant Agreement
Applicant must read and sign
• Each application package must contain 4 foided copies of all plans and documents being submitted. Only 1 set of
material/color samples is required. All submittal items become the property of Albemarle County. Applicants are
encouraged to maintain duplicate copies in their own files.
• The application package is not complete without this checklist, completed, signed, and included with the rvquimd
submittal materials indicated on the checklist.
I hereby certify that the information provided on this application and accompanying information is accurate, true and
correct to the best of my knowledge and belief and contains all information required by these checklists
02121 /20
Signature of person completing checklist Date
Peter Gropper 434-979-7275
Printed Name / Title Daytime phone number of Signatory
County of Albemarle Department of Community Development
401 McIntire Road, North Wing, Charlottesville, VA 22902-4596
(434) 296-5832 Tel, (434) 972-4126 Fax
www.albemarle.ora
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