HomeMy WebLinkAboutTS201500120 Application 2015-10-12Application for
Temporary Sign Permit
APPLICATION REQUIREMENTS:
Temporary Sign Pen -nit = $25
Cl A picture or sketch of sign showing diniensions and location of sign on property must be attached with
this application.
[,- Certification that notice of this application has been provided to the property owner, if owner is different
from applicant.
Name on Sign 1 Business Name:
Location of sign 1 Pre-- `
Tax Map and Parcel:
Physical Street Addre
ApplicanttZine IOwner(who shouldwecalllwriteemcsmins*bprnject:y): r
Address% t - City )(Ir state 04 ZiDJ-)� � �j
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Daytime Phone f—n9Cv(i Fax Email i n� o li �� �^'�" re'.-$cj_._Cglrl
Owner of Record
What number permit is this for your business this year?
(check one) (this will be verified by staff)
El lot ❑ 20" �Yd 041h ❑ sib ❑ 61b
What type of temporary sign are you proposing?
(check one)
❑ BANKER] PORTABLE C]A-FRAME
Depending on the zoning district the maximum height of the sign will be
(check ane)
12 feet if freestanding ❑ 20 feet if on a wall [] 30 feet if on a wall
The required setback from public street right of way will be
5 feet
Signature
Issued/Approved By
Depending on the zoning district the maximum size. of the sign will be
El 24 square fedi �J 32 square feet
D" tes you are requesting the sign to be in place.
L Z[ through i U 34
When entering the dates above, please keep in mind the following
information:
o Each permit for a temporary sign shall be valid for 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.
g A maximum of two permits will be accepted for review for
each establishment at one title.
Please note that an establishment is not
permitted more than sixty (60) days.of
Date
Date
OFFICE U$E O�.Y ,/�
Fee anioant b X7 ' Datc Paid 6 `�) Check # 110L 5 By Who?IJ l i 4"V iteccipt #1016 7 By: Petruit #
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5932 Fax: (434) 972-A126
412612012 Pagel I of 1
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CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
ER
This ford: must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application,
[County application name and number]
was provided toa-- 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
;Wanner 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 off`` ices for
that entity]
on l
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].
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Date
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