HomeMy WebLinkAboutTS201600012 Application 2016-03-14Application for
Temporary Sign Permit
❑ 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: C rs",-] /\Z ! rn 0 J -S f til 1E
Location of sign / Property: 10 1 ` (C) 3 FT. b ►� C C� �,�
Tag Map and Parcel: 1 r V Zoning/: a€f C(
Physical street Address (if assigned): % C7 ✓• 0.� 011 rel C
Applicant/Rusiness Owner (Who should we call/writc concerning this project''): r ! ! U
Address 1036 /6 A, City �- L �: T���t°L tate I/ /�_ Zip
Daytime Phone &_ d X2_5_ ,)y / `&//# E-mail -}
l) A
Owner of Record l 1/—c•
Please fill out the followine:
What number permit is this for your business this year?
(check one) (this will be verified by staff)
Depending on the zoning district the maximum size of the sign will b
`f!�24 square feet ❑ 32 square feet
1a ❑ 2nd El 3rd E-] 4rn E] 5`h ❑ 6a' Dates you W requesting the sign to be in place-
1 s j t�: through f,�
What type of temporary sign are you proposing? ---•-
(cheek one) Z�
❑ BANNER ❑ PORTABLE 2!PA-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 4*n,.r's / Agent's Signature
Issued/Approved By
When entering the 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 oftwo permits will be accepted for review for
each establishment at one time.
• Please note that an establishment is not
permitted more than sixty M day of
temoorary signs in a calendar near.
3 d
/I bite
OFFICE USE ONLY Camyfn ExecwliNt lfaYls.
Feeamount$ 2-1 'c - DatePaid3j/ bl, Check# 5902 Bywho? 0 LimouEiM Rmeipt#to�Iq—BY_ZLL P.—I?-
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Far: (434) 972-4126
APM1701I Poor 1 -f
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, 4,V oe 1,,4-- 11
[County application name and number]
was provided to PdC Q/ U' the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number ori I Pr-�C delivering a copy of the application in the
manner identified below;
r �
%/ 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
c;t f(I
�
Date
Mailing a copy of the application to Tt tzr
[Name of the reebrid 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:
Icj `l �) -Y& 1.�- La,2, (i,` �T �'�lf`i� U, �Ia • UPJ [ (I
[address; written notice mailed to the owirer 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].
A��-
SighaWf')kpplicant
A,
Print Applicant Name
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I CA
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Location of temp
sign
Camryn Limousine application for temporary 15 day road sign