HomeMy WebLinkAboutTS202200026 Application 2022-11-04Temporary Sign Permit Application
FOR OFFICE USE ONLY Sign Number:
Fee Amount: $ 31.20 Date Paid: By
Application fee: $30+ Technology Surcharge: $1.20
Receipt #: Check #: —rail/ Rv
Albemarle County
C.. nay D eloP—t
C' mama. Rd NWh Wa
Charlaenni VA 22902
Phme 43 2%salt
Name: 77 6 ivy cHrtis9n -Mall Address: '1,4 LIASN G-ham
s
MallingAddress: L' wri %nG1.N9R. Phone#:
BuslnessName: y<SEpf{ ASnELLAcN
Tax Map and Parcel #
Zoning:
and/or Address of the Business: 4 -' 1 3 Z-
Staff will fill out fi unknown
Parcel Owner: CWR(eiEfV l l I P
s A„Or
Owners Address:
d
�lov 1Qw �t Cca aiiF
Please fill out the following:
What number permit is this for
Your business this year?
�/ "
(check one)
2aa
❑ Sth ❑ 61h
❑ 34" ❑
(this will be verified by staff)
-t- NEEp .? _Dr1 V S
What type of temporary sign are
❑
you proposing?
BANNER L� PORTABLE 9 A -FRAME
(check one)
Depending on the zoning
district the maximum height of
12 feet ❑ 20 feet ❑ 30 feet
the sign will be
if freestanding if on a wall if on a wall
(check one)
The required setback from
public street right-of-way will be
S feet
Depending on the zoning
district the maximum size of the
�'� !
❑ 24 square feet J2 square feet
sign will be
Dates you are requesting the
sign to be in place.
rft.
/Vot.em dEr� 22LLthrough 3
When entering the dates above, please keep in mind the following information:
Each permit for a temporary sign shall be valid for a period not to exceed fifteen (15) consecutive days after the erection of
the sign.
The Ordinance requires the sign to come down between permits and will be approved on -site by a Code Compliance
Officer during regular business hours only.
A maximum of two permits will be accepted for review for each establishment at one time.
Please note that an establishment is not Permitted more than sixty (60) days of temoorary signs in a calendar year
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.
Signature "`'' _- Printed Yo S G %�'% 4 S r e L t %i i ft
M.r. / / 17.17 - 7 9
at r / r -- .-ate
Temporary
Sign
Permit Application
ounty
Rd MOM W Vfsq
�Ol Mclnba A l AR MOMW
FITMfihsrl qs�,VA22B
Phone 4 286 5=
Applicant - If you are not the land owner, please fill out the entire page below confirming that you have either
informed or are going to inform the owner of your application.
CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN
PROVIDED TO THE LANDOWNER
I certify that I will provide (or have provided) notice of this clearance application,
56 t ti%E(?PPTSE LI7TU= !'CveY. C'4..� A�j
to C0191,c-717E 5u;11C Hio u � the owner
of Tax Map and Parcel Number / -/ ' by either delivering a
copy of the application to them in person or by sending them a copy of the application by
mail. (Please check one of the following below)
Hand delivering a copy of the application to the owner identified above on
Date
L�Mailing a copyofthe application to the owner identified above on
Date )i I i / z 1 to the following address:
(Written notice to the owner and last known address on our record books will satisfy this
requirement. Please see staff for help determining this information if needed)
Signature of Applicant
Applicant Name Printed v- 5 e Pi 1 RL Sn EL 6/q5
Date
0 2
i
1
±tit
w
i
'a
'ICPrnY
�
—. -
g(A
+
A
r
�
9