HomeMy WebLinkAboutARB201100025 Legacy Document 2011-05-27A
Application and Checklist for Sign Permit
Part A: Applicant and Parcel Information
Project Name: I (� Fce yn a Address: w. c ( e Tura I
Tax map and parcel(s): Zoning:
Contact Person (Who should we calUwrite concerning this project?): - I e a V �I '(-
Address Soo U),. l �& v .A rC 1 5,U-) City C- .- ✓ (Z rte' J s State i A ___ Zip 5 24 A q
Daytime Phone ( -r -b 84 f3- t- on Fax #(ai9)8(4 e -3e- tS E -mail AIn I{�
Owner of Record: A) mv n in
Address 1" l O A Li is I r S 'V City State C O Zip ° 0 2 0 3
Daytime Phone(yA3) P, (_ 3, — S q Pax# L—) E -mail
Contractor Name/Business Name: `` . to S
Address � 0 s5 l a ( -Y-o v- 3 P— S W City C' I ✓ t2 ' I state iA Zip C z 4 o
i
Daytime Phone (i i 4) 8 4 8- 3(� o o Fax # &f) s 4 €i - 3 G i S E -mail
Part B: Determining application requirements and fees
1.
Sign Permit- Please indicate whiclm sign typeyou are applyingfor:
Freestanding or Monument Sign:
$95.60
❑
If a footing is required, an additional fee is required:
$30.60
Wall Sign (Including property, awning, fuel pump canopy signs):
$95.60
❑
Sign Refacing:
$65.00
2.
Electrical Permit - Will the sign be illuminated?
Yes (Illuminated signs require an electrical permit and an electrical schema tic.)
$45.90
❑
No
$ 0.00
3.
ARB Review - Will the permanent sign(s) be constructed in an Entrance Corridor?
(See the Entrance Corridor map in the Sign Permit Application packet for a list of Entrance Corridors.)
❑
Yes (This sign will be constructed in an Entrance Corridor and it does not meet the conditions ofa
$75.00
Comprehensive Sign Review. See ARB requirements next pages.)
❑
Yes (This sign will be constructed in an Entrance Corridor and it does meet the conditions ofa
Waive Fee
Comprehensive Sign Review. See ARB requirements next pages.)
❑
No (This sign will not be constructed in an Entrance Corridor)
$ 0.00
FEE
TOTAL (Please add all the amounts checked in sections 1- 3):
$
FOROFFICEUSEONLY BP# ARB#
Fro Amount
$ Date Paid By who? Receipt # Check #
By
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
09/02/2010 Page I of 4
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.
I hereby certify that the information provided on this application and accompanying information is accurate, true and
correct to the best ofmy knowledge and beliefand contains all information required by these checklists
Signature of person completing checklist Date
( -"-1`i�64L— 3� 00
Printed Name / Title Daytime phone number of Signatory
County of Albemarle Department of Community Development
401 McIntire Road, North Wing, Charlottesville, VA 22902 -4596
(434) 296 -5832 Tel, (434) 972 -4126 Fax
www.albemarle.ore
01/05/201 I Page 4 of 4
Sign Diagrams
Sign Dimensions
Sign
Height
Distance tl o property line
or edge of right -of -way
Sign Height =
Sign Dimensions =
Pole- Mounted Sign — Diagram 1
(Generally not acceptable in the ECs)
Wall Sign — Diagram 3
Sign 2 Height =
Sign 2 Dimensions =
Sign 3 Height =
Sign 3 Dimensions =
Sign Dimensions
Sign
Height
Distance to property line
or edge of right -of -way
Sign Height =
Sign Dimensions =
Monument Sign — Diagram 2
If multiple wall signs are proposed, list dimensions here:
Sign 4 Height =
Sign 4 Dimensions =
Sign 5 Height =
Sign 5 Dimensions =
Sign Diagrams revised 712009 — 1
Sign
Height
Si Dimensions
9n
Building Frontage
Building Frontage = (0 5
Sign Height = 2D
Sign Dimensions= r r 1
Wall Sign — Diagram 3
Sign 2 Height =
Sign 2 Dimensions =
Sign 3 Height =
Sign 3 Dimensions =
Sign Dimensions
Sign
Height
Distance to property line
or edge of right -of -way
Sign Height =
Sign Dimensions =
Monument Sign — Diagram 2
If multiple wall signs are proposed, list dimensions here:
Sign 4 Height =
Sign 4 Dimensions =
Sign 5 Height =
Sign 5 Dimensions =
Sign Diagrams revised 712009 — 1
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