HomeMy WebLinkAboutTS202300011 Application 2023-03-28SOFA
��� I,II Albemarle County
Temporary Sign Permit Application Commvniin NMni
401 McIntire Rd,Rd NarN Wing
Chatlottesville, VA 22902
�rRGINv1' Phone 434.296.5832
FOR OFFICE USE ONLY Sign NumbermmZO2 'I
Fee Amount: $ 31.20 Date Paid �'74I' Q Byt)WV
Z5
Application fee: $30+ Technology Surcharge: $1.20 25
Receipt #:12MIq f Check #�% Vq Bv<&We%*-W AC /""^As
Name:
tC Dew
E-Mail Address: 5-�I1oF5Ci`C &
Mailing Address:
�3 Mos9y � a V,1
Phone # (703) 92 -�7y
Business Name:
Or e H aA,#1 L.-C
Tax Map and Parcel #
Zoning;
P -P f"w/�4,e
and/or Address of the Business:
0 $06-06-00—017Dfo
Staffwll fillouti(unkmw.n
Parcel Owner:
poNDeeosy { /1N7� T2vs i
Owner's Address:
72y /y'YS%A/.w, cHazadv/�¢
Please fill out the following:
What number permit is this for
your business this year?
(check one)
�1et ❑ 2nd 3rd 4th 5m 6th
❑ ❑
(this will be verified by staff)
What type of temporary sign are
you proposing?
❑ BANNER ❑ PORTABLE �A-FRAME
(check one)
Depending on the zoning
district the maximum height of
12 feet El feet El 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
Depending on the zoning
district the maximum size of the
❑ 24 square feet �2 square feet
sign will be
Dates you are requesting the
sign to be in place.
r—
2/ sr through T �r 5' ,12o23
When entering the dates above, please keep in mind the following information: `VLk •'S
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
The Ordinance requires the sign to come down between permits and will be approved on -site by a Code Compliance ADDITIONALTIME
Officer during regular business hours only. ALLOWED DURING
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 (60) days of temporary sians 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 ✓i'-r'vyLZL 6. as/�<!f/1�
Dale 3 2 3
.,Cq �F ALB
J� 11 Albemarle earlCounty
Temporary Sign Permit Application E� 401 McIntire Rd, North Wing
Charlotteaville, VA 22902
R Phone 434.296.5632
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 DWV-D #4 ea7isf, 22y/9''Sr'VW the owner
of Tax Map and Parcel Number 07900 -oo -oo - 0 / ?D6 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
14/1 Mailing a copy of the application to the owner identified above on
Date ;3 , 20, z3 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 J21WW4 do S,51
Date 3
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(7o3) 9,)17- 2/718
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Initials' ny Page 3
Add Expiration Date
Edit Expiration Date
Current Deadline:
https://woodardproperties.nal.echosign.com/public/viewA9r... F9UZsb4JyGw SRkligchxPx1WHrRbm29t owevw3U_xNyS4X& 1213120, 9:14 PM
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