HomeMy WebLinkAboutTS201600003 Application 2016-03-14Application for
Temporary Sign Permit
❑ Temporary Sign Permit W $27
,ATTACHA PICTURE OR SK l: TC11 OF SIC N SI OC VlNG Di'MENSi4)N'1 AND LOC ATION (t:' Till_ 1'Itttl FAt VY
Name on Sign / Business Name: _ , � raN _ C f—t
Location of Sign / Property: 19 (0 111 Lc- C,sd^,-�
Tax Map and Parcel: Zoning:
Physical Street Address (if assigned): Sqfi1[.
Applicant/Business Owner (Who should we call/write concerning this project?):I EL_ FPr 3F_.�__
1310 j A yLO 4_
AddressCity SNE#',X State ,/A Zip 2 `i i 5
Daytime Phone (5�1 29q —p4rqy Fax #
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)
ElIr ❑ 2nd ❑ Yd ❑ 4th
What type of temporary sign are you proposing?
(check one)
Er -BANNER [:]PORTABLE ❑ A -FRAME
Depending on the zoning district the maximum height of the sign will be
(check one)
[�]'2 feet if freestanding ❑ 20 feet if on a wall ❑ 30 feet if on a wall
(See 18-4.15.8 - 184.15.14)
Depending on the zoning district the required
setback from public street right of way will be
(check one)
�5 feet ❑ 10 feet
(See 184.15.8 - 18-4.15.14)
E-mail L 1T5-. Coln
Depending on the zoning district the maximum size of the sign will be
(check one)
�4 square feet ❑ 32 square feet
(See 18-4.15.8 - 184.15.14)
Dates you are requesting the sign to be in place.
(v
-through,;?-/ r% �b
When entering the dates above, please keep in mind the following
information:
%
Each p*mit for � tsmporaty Sign shall be valid for a period not WA
fi een (15) coxaecutjve days after -the erection of the st
, . b 03 dint ee requires the sip to coin dawn—bet—ween permits ari
ill bwapproved on-site by Code Enforcement Officer during.?-
N- gular business hours only.
�wdErium of t it permits will be accepted for review for eac
rrlishment at one tib,j
�/� i/2(, //
Q
Property Owner's / Agent's Signature Date
Issued/Approved By Date
OFFICE iLY � � y .Lp y 5
Fee amount $ Date Paid Check # B Who? l Recei t # B Permit #
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
�0 , ` f-,(Nrn. �� 11/1/2015 Page l of 1.
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,
was provided to
[County application name and number]
[name{s} of the record owners of the parcel]
the owner of record of Tax Map
and Parcel Number by delivering a copy of the application in the
manner identified below:
l/ riHand delivering a copy of the application to j'�,-56
[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
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
Date
to the following address:
[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 Applicant
Print Applicant Name
/Z6114
Dat