HomeMy WebLinkAboutARB202200080 Application 2022-08-24ay
Application and Checklist for Sign Permit
Part A: ApplicantandParcel Information
Project Name: Rack Pooh/ Shce_r�
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Address: 1750 Rso l7i//tne!?`C�
Tax map and rcel s : Limo-0 —0 — 61qqlqo
Zoning: CDNtM.
Name; grl0n
Contact Na
O/ K lef- Business Name:AAW"Can !e /�i ade1
(Who should we call w/ questions?)
Address 1107 Ell/Q/it�ti-T S>F City
/i / �%/ Zip -2�7 413
Daytime Phone(t�iT 971-7qlFioli( )
E-mail mifS �dMey4!a&n fM
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Contractor Name: :8"6n
Business Name: /f VtfK'/
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Address c�6i/I%C kaec,tN
State Zip
Daytime Phone (_) Faax # �)
E-mail
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Business Name: rr
Business Owner Na-me:
Address Q'8we
State Zip
Daytime Phone ( ) Fax H C__)
E-mail
Part B: Determining application requirements and fees (includes 4% Technology Surcharge)
NOTE: Fees are calculated PER SIGN. If you have 2 or more signs, nil out separate applications for each sign.
1. Sign Permit - Please indicate which sign type you are applying for:
❑ Freestanding or Monument Sign: $123.30
❑ If a footing is required, an additional fee is required: $54.06
Wall Sign (including property, awning, fuel pump canopy signs) Up to three wall signs per establishment may $123.30
be included on one permit meeting applicable s¢e requirements. On(v one fee for all three wall signs will be assessed.
❑ Sign Refacing: $85.60
2. Electrical Permit - Will the sign be illuminated?
Yes (Illuminated signs require an electrical permit and an electrical schemada) $73.14
❑ No $ 0.00
3. ARB Review -Will the permanent sign(s) be constructed in an Entrance Corridor?
(Go to hnps //wwx ulbemarle.org/govemmenVwmmunitvdeveloomenUadvisory-boardVaNhileclural-review-board for more infbmalion.)
❑ Yes (Review by Architectural Review Board See ARB requirements nest pages.) $147.68
Yes (Review by ARB Stag See ARB requirements next pages. $135.20
❑ Yes Resubmittal of a sign application $ 67.60
t W No (This sign will not be constructed in an Entrance Corridor)
FEE TOTAL (Please add all the amounts checked in sections I - 3):
FOR OFFICE USE ONLY BPN
Fee Amount $ Date Paid By who? Receipt M Check N
By
$ 0.00
County of Albemarle Community Development Department
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
www.albemarle.ore 08/2021 Page I of
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RECEIVED
COMMUNITY
DEVELOPMEr:-
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SECTION 4: WORK VALUATION
A. Work Valuation 9;��Cyfl
Part D: Applicant Agreement
Applicant must read and sign
• Each application package must contain 4 folded 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 required
submittal materials indicated on the checklist.
1 hereby certify, that information provided on this application and accompanying information is accurate, true and
correct to th est of m knowledge and belief and contains all information required by these checklists
S fL3 L2--L-
Signatu e o person completing checklist Date
Z24�' , ) e 4/61
Printed Name / Title z Daytime phone number of Signatory
County of Albemarle Community Development Department
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 2%-5832 Fax: (434) 972-4126
www.albemarle.ore 08/2021 Page 4of4