HomeMy WebLinkAboutTS202300012 Application 2023-03-28$�q of
Temporary Sign Permit Application,.
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FOR OFFICE USE ONLY
Fee Amount: $ 31.20
Application fee: $30+ Technology Surcharge: $1.20
Receipt #: 8A I
Sign Numb
Date Paid: /ZS�Z3 By: PWO
Albemarle County
Community Development
401 McIntire Rd, North Wing
Charlottesville, VA 22902
Phone 434.296 5832
M MOR1171FA
Name:
EA50A60F N Lt smwN
E-Mail Address:
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Mailing Address:
gowToHa/Nos3Y N AaDrF W6
Phone #:
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Business Name:
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Tax Map and Parcel #
Zoning:
and/or Address of the Business:
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Staff will fill out if unknown
Parcel Owner:
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Owner's Address:
IJ4 M(nlo LCC Ch4eo
Please fill out the following:
What number permit is this for
your business this year?
�t ❑ 2nd 1:13rd ❑ 4th 5th ❑ sth
u '
(check one)
(this will be verified by staff)
What type of temporary sign are
❑ ❑ ZA-FRAME
you proposing?
BANNER PORTABLE
(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
5 feet
public street right-of-way will be
Depending on the zoning
district the maximum size of the
24 square feet 32 square feet
sign will be
Dates you are requesting the
g j CT#
2 -AUf-i ✓
sign to be in place.
through 12023
When entering the dates above, please keep in mind the following information: ,, , _M
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
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 (60) 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 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.
SignatureePrinted
Date 15—
,l OF A
2� it Albemarle County
Temporary Sign Permit Application Community Denilmment
North
401 McIntire Rd North Wing
a` Chadotteaville, VA 22902
YIRG(N�* Phone 434.295.%K
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 60, CHtti the owner
of Tax Map and Parcel Number 061 KOO2 QAQQZO0 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
Mailing a copy of the application to the owner identified above on
Date 3 t ZO• Z.3 to the following address:
// K Jemwozec T2f/iL , C1t�ee oi3 ✓ ll-F ,yA ,
(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 ,D4WY''4L G - 5/—/0ND
Date .3- is • Z3
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