HomeMy WebLinkAboutTS202200020 Application 2022-06-27Temporary Sign
FOR OFFICE USE ONLY
Fee Amount: $ 31.20
Application fee: $30+ Technology Surcharge: $1.20
Receipt* 19531Z —
Name:
Mailing Address:
Business Name:
Tax Map and Parcel #
and/or Address of the Business:
Parcel Owner:
What number permit is this for
your business this year?
(check one)
(this will be verified by staff)
What type of temporary sign are
you proposing?
(check one)
Depending on the zoning
district the maximum height of
the sign will be
(check one)
The required setback from
public street right-of-way will be
Albemarle County
_ con hiry Development
01 Ing
Permit Application 4h.do,. ree. VA 22h 2
' Charlottesville. VA 229(12
Phone 434. 296.58.32
Sign Number: -rs l Z- 0002-o ,
Date Paid: (P I In (ZZ By: ( ,Lit VGwj Chapel
Check#: UNLI By: Dhb
M LC E-Mail Address: CCGy`�lel o@�^lu�ti
Phone #: y 3 y -
�� IroU -da-0o - o53,31D ILOningl:
Stag will fill out it unknown
Owner's Address:'
Please fill out the followlna:
1st ❑ 2nn 0 3`a E] 4th
L7 BANNER ❑ PORTABLE
tr 12 feet
if freestanding
❑ 20 feet
if on a wall
5 feet
PEE
❑ 5u' ❑ 6th
❑ A -FRAME
❑ 30 feet
if on a wail
M
the zoning �4 square feet ❑ 32 square feet
aximum size of the
e requesting the throughplace. PEASE SEETHE
When entering the dates above, please keep in mind the following information: ATTACHED POU14
Each permit for a temporary sign shall be valid for a period not to exceed fifteen (1REGARDING5) consecutive days after the erection o ADDITIONAL TIME
the sign.
roved on -site by a Code Compliance ALLOWED DURIMy
The Ordinance requires the sign to come down between permits and will be approved THE CO- - d�
Officer during regular business hours only. DISASTER
A maximum of two permits will be accepted for review for each establishment at one time.^^"n C1nns in a calendar near. ,
Review of this application cannot begin until the application is complete and all applicable attachments and fees are submitted
This permit will only be valid on the parcel for which it is approved.
I hereby certify that I own or have the owner's permission to use the space indicated on this application. I also certify that the
information provided is true and accurate to the best of my knowledge. I have read the conditions of approval, and I understand them, and that
I will abide by them.
Printed
Signature
f
Date
X
00
rt
LoC.4