HomeMy WebLinkAboutTS201500152 Application 2015-12-21Application for
Temporary Sign Permit
APPLICATION 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
from applicant.
Name on Sign / Business Name: f
Location of Sign / Property: 0 1 ( c_) 3 ���%� fJ t' I C� CLi? L �C l �.J,
Taal Map and Parcel: 40 l Zoning; `p A -K
Physical Street Address (if assigned): 0 3 15 -U l taZ- vi I I
ApplicantlBusiness Owner (who should we cat write concerning this project?): HU V
Address /0 f'7 L` - City [��{��-�v� 6 State Zip —!—Z—i//
Daytime Phone{��s Wax # E-mail !i A.!
Owner of Record 6111
Please fill out the followinz
What number permit is this for your business this year?
(check one) (this will be verified by staff)
❑ tad ❑ 3rd )K41h ❑ 5th ❑ 6th
What type of temporary sign are you proposing?
(check one)
❑ BANNER [-]PORTABLE 0!�A-FRAME
Depending on the zoning district the maximum height of the sign will be
(check one)
VI 12 feet if freestanding ❑ 20 feet if on a w ail ❑ 30 feet if on a wall
The required setback from public street right of way will be
5 feet
Property 4*n&'s /Agent's Signature
Issued/Approved By
OFFICE U Y
Fee amount $ Date Paidf-&-b_ Check #.M VjQ— By
Depending on the zoning district the maximum size of the sign will b
'E�24 square feet ❑ 32 square feet
Dates you gw requesting the sign to he in place_
through���
When entering tate dates above, please keep in mind the following
information:
• Each permit for a temporary sign shall be valid for a period
not to exceed fifteen (15) consecutive days after the erectio
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,
• Please note that an establishment is not
permitted more than sixty (60) days of
temporary signs in a calendar year.
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-58M Fax: (434) 9724126
Permit #Cl it -�] "
AP)A1')n1'7 Paa& i of
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 or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, -4v 10 -r.11 rte--" �f /
[County application name and number]
-41 was provided to C df u�
the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number ccrL
manner identified below: y delivering a copy of the application in the
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 f
Date ` T
Mailing a copy of the application to TU� - lQ 'r"
[Name of the redord 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
3 i� N�
to the following address:
_ IU116'. 9 it
[address; written notice mailed to the ow er at the last known address of the o as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Ad7--
Signa f pplicant
—/ —
A ��-
Print Applicant Name
I c ��
Da , w
7q
slown
CIO
s
0
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Location of tern
sign
' J;'. - !:u,
06
Camryn Limousine application for temporary 15 day road sign