HomeMy WebLinkAboutTS201500121 Application 2016-01-25Application for
Temporary Sign Permit
APPLICATION REQUIREMENTS:
❑ Temporary Sign Permit = $25
❑ A picture or sketch of sign showing dimensions and location of sigh on property must be attached with
this application.
[j Certification that notice of this application has been provided to the property owner, if owner is different
from applicant.
Name on Sign / Business Name: __u lrl`LL1n J
Location of Sign f Property: 35'
Tax Map and Parcel:
Physical Street Addre
Applicant/Business Owner ( Who should we call/write concerning this pmjecM:
0c�Address1. & b_„, i .•L4 I
Daytime Phone AN) 531 M04 Fax #i
Owner of Record
Please fill out jhq following:
What number permit Is this for your business this year?
(check one) (this will be verified by staff)
❑ lot 2ed ❑ 3rd ❑ 41h ❑errs ❑ 6d&
What type of temporary sign are you proposing?
(check one)
❑ BANNER �PORTABLE C1 A -FRAME
Depending on the zoning district the snnaximum height of the sign will he
(check one)
12 feet if freestanding ❑ 20 feet if on a will ❑ 30 feet if on a wall
The required setback from public street right of way will be
5 feet
A
Issued/Approved By
state Vr” Zip2!709'
E-mail t4b_C .;J�� .. C' , L(r
Depending on the zoning district the maximum size of the sigh will be
❑ 24 square feet �32 square feet
Dates you are requesting the sign to be in place.
is 2.1 through_i
When entering the dates above, please keep in mind the following
information:
Each permit for a temporary sign ahetl 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.
• 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 AM (60) days of
0/ 1 he:
Date
OFFICE 115E O}aV_ %1-111Fee amount $ Date Paid 10 - 6-r 1 Check # l t X3 0 By Who? UA � -eL l � Receipt 0 1 b 1410% By; �5X'UC reit # � �o t
County of Albemarle Department of Community Development
401 McIntire Read Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4128
4/2612012 Page 1 of 1
CERTIFICATI®N TI AT NOTICE OF TIE
APPLICATION HAS BEEN PROVIDED TO THE'LANDOWNER
?Itis fora: 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 to .[e(s) of _
the owner of record of Tax Map
the record
owners of the parcel]
and Parcel Number
inwriet identified below.
by delivering a copy of the application in the
Hand delivering a copy of the application to &U sn '.S -U , ,4
[Name of the record owfier 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_(D It ('
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 thatyeatity]
on I t:, t..,. l l "j to the following address;
Date
[address; written notice mailed to the owner at the last lmown 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 A15f licant }}
l Y -C, C v�
Print Applicant Name
Bate
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CD
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