HomeMy WebLinkAboutTS201500140 Application 2015-12-02Application for
Temporary Sign Permit
AP9XICATION REQUIREMENTS:
Temporary Sign Permit = $25
Lj 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
from amlicant.
Name on Sign / Business Name: NZ l
Location of Sign / Property:
Tag Map and Parcel: J 0 D Oe' I L mss/ -t V Zoning:. 'l� Q
Physical Street Address (if assigned): v -3 l &X iIF
k,, f7u V
ApplicantlBusiness Owner (Who should me WI/writeeccoacm ing this prajwM:
Address / [� l� City f'rr— v �6 State Zip �f
Daytime Phone 64
i�J � �� �`"�'ax # —E-mail d A.! Gtr
Owner of Record 61 l l C--g—d v� t- '_
Please fill out the followin .
What number permit is this for your business this year?
(check one) (this will be verified by staft)
Depending on the zoning district the maximum size of the sign will b
1!124 square feet ❑ 32 square feet
1 ❑ 2°a ❑ 3ia ❑ 4m ❑ 5th ❑ 6t'' Dates you W requesting the signtobei n place.
What type of temporary sign are you proposing?
I ,� I ) P !� through_ "
(check one)
❑ BANNER ❑ PORTABLE ff A -•FRAME
Depending on the zoning district the maximum height of the sign will be
(check one)
V] 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
Property n 's / Agent's Signature
By
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 erectio
ofthe 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.
Please note that an establishment is not
permitted more than sixty (60)_ days of
temporary signs in a calendar veer.
it l I-)) 65
���
Date
OFFICE USE ONLY
Fee amount S �vl Date Paid ' I Bio Check # S0 6
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fag: (434) 9724126 art�r�nt� nP rtt
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
Ais forme must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) ifthe application is not the
owner.
I certify that notice of the application, 4, 1, aX. rt `�Y•^/ f
[County application name and number]
was provided to SPdc,, of the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and parcel Number —3 �(26�'-/l ) pcz2 delivering a copy of the application in the
manner identified below:
ti/ 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 _
Date ' z
Mailing a copy of the application to -TU �Z -
[Name of the re ord 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
Date
to the following address:
02&4 F1�i#�.' ;y q • I
[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].
69��-
Signa f pplicant
A, -'),
Print Applicant Name
DZ�
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Camryn Limousine application for temporary 15 day road sign