HomeMy WebLinkAboutTS201500117 Application 2015-09-23h
Application for
Temporary Sign Permit
M
AP1,laCATION REQUIREMENTS:
'Temporary Sign Permit = $25
❑ A picture or sketch of sign showing dimensions and location of sign on property must be attached with
this application.
❑ Certification that notice of this application has been provided to the property owner, if owner is different
Name on Sign IBusiness Name: 2 Z/2 E
/ / 4�
Location of Sign /Property: '/7 �c?7s.� f . .Q✓ �� %e
Tax Map and Parcel: —. " �- Zoning:
Physical Street Address (if assigned):
Applicant/Business Owner (Who should we cailiwrite oanceming this pm)ecrrr); %��(�/� •{ ir��
Address _ 9� 6e city State "�--- Zip 2 2i 3Z
Daytime Phone ( Irg Fax # E-mail C�t/�ir . s��jy4./P 9wac,'/ice
Owner of Record
Please fill out the followine:
What number permit is this for your business this year?
(check one) (this will be verified by staff}
01ut1:12na El Yd ��e 1:1 1:1 ❑ 61'
What type of temporary sign are you proposing?
(check one)
R ❑ PORTABLE ❑ A -FRAME
Depending on the zoning district the maximum height of the sign will be
(check one)
12 feet if freestanding ❑ 20 feet if an a wall [:130 feet if on a wall
The required setback from public street right of way will be
5 feet
Property Owner's / Agent's
Issued/Approved By
Depending on a zoning district the maximum size ofthe sign will be
24 square feet ❑ 32 square feet
Dates you are reauep";^n the sign to be in plane.
G
through'
When entering the dates above, please keep in mind the following
information:
• Each permit for a temporary sign shall be valid fnr 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
Enforcement Officer during regular business hours only.
• A maximum of two permits will be accepted for review for
each establishment at one time.
• Pie? se note that an establishment is not
permitted more than sixt-tXL60) days of
Date
,3
OFFICE UE ONLY ` `
Fee amount $ S. ° Date Paid S hecft # �� j By Who? 1 Receipt #10 1 `'i3 O By; �-F"M t # �! 3 I F7
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
4/26/20I2 Page I of I
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations orAppeals, Sign Permits, Building Permits) if the application is not tl:e
owner,
! certify that notice of the application,
[County application name and number]
was provided to /� r 2_ 7 the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on �6
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an entity, identify the recipient of the record and the recipient's title or
office for that entity]
on to the following address:
Date
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Signature of A6plicant
Print Applican Narne
Date
-�k- 'oe-kez'e.--e 4-410��