HomeMy WebLinkAboutTS202300007 Application 2023-03-02Temporary Sign Permit Application
FOR OFFICE USE ONLY Sign Number
Fee Amount: $ 31.20 Date Paid_
Application fee: $30+ Technology Surcharge: $120
Receipt # Check #:
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Albemarle County
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Comm fty DeV opme
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401 MaM m Rd, Nodh Wing
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Chaftft" i®e, VA 22902
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Phone 434296.5=
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Name: -114445T-IM `A*j
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E-Mail Address:
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Mailing Address:
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Business Name:
I S t is r )12i} iisr LL C
Tax Map and Parcel #.ApecthNDiub-
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and/or Address of the Business:
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Staff win fit out if unlmovm
Parcel Owner:
F'ry ;W4if "C-
Owner's Address:
2, LtN r V!
Please fill out the following: St! f ►C9 GJi Z1�J
What number permit is this for
your business this year? [K1s1 #2nd ❑ 3rd ❑ 4t" ❑ S1e ❑ Sth
(check one)
(this will be verged by staff)
What type of temporary sign are
❑ ❑
you proposing? Pl BANNER PORTABLE A -FRAME
(check one)
Depending on the zoning
l ❑
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
5 feet
V24 square feet ❑ 32 square feet
Depending on the zoning
district the maximum size of the
sign will be
Dates you are requesting the �t!!�� y: 202 �7 lMl1R 1-7? Ali
sign to be in place. through
When entering the dates above, please keep in mind the following information: PLEASE SEE THE
Each permit for a temporary sign shall be valid for a period not to exceed fifteen (15) consecutive days after the erection of ATTACHED POLICY
the sign. REGARDING
ADDITIONALTIME
The Ordinance requires the sign to come down between permits and will be approved on -site by a Code Compliance
ALLOWED DURING I
Officer during regular business hours only.
THE COVID-19
A maximum of two permits will be accepted for review for each establishment at one time. DISASTER
Please note that an establishment is not permitted more than sixty (601 days of temporary 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 owners permission to use the space indicated on this application. I also certify that the
information provided is true apid 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.
/ 1
Signature Printed
Date %
V
Albemarle County
Temporary Sign Permit Application ComnuryN Oay. NorthCor Mgn9re Rd. Nop ntWing
ChWottvNM, VA 22902
Phom 434296.5832
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,
to �1 w�s'"1+t-e'4 i L L` the owner
of Tax Map and Parcel Number 601 yt� �f� ` �"`�' n ()'" 4 W&f 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
jd Mailing a copy of the application to the owner identified above on
Date 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
Date
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v- 2
2
RECEIVED
COMMUNITY
DEVELOPMENT
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