HomeMy WebLinkAboutTS201600024 Application 2016-05-04Application for
Temoora
Sign Permit
le'Temporary Sign Permit = $27
ATTACH A PICTURE OR SKETCH OF SIGN SHOWING DIMENSIONS AND LOCATION ON THE PROPERTY
Name on Sign / Business Name: _ �[� Vyl ins cx SScA e p_�—
Location of Sign 1 Property: — J V�-s°��5
i
Tax Map and Parcel: L _ _- Zoning: 1 C
Physical Street Address (if assigned):
Applieant/Busfness Owner 41lho should u•e calll%Witc concemufg this pro)ect' ). t-9 �I} 1
Address_ �!�— , -%V�. c.ornma�?S city ,har_l�a�e5u fle State kjf! zip
Daytime Phone cc r I� _ _`�= 7 �� Fax # L'•-mail�—
Owner of Record
Please fill out the followin :
What number permit is -.his for your business this year?
(check one) (this will be verified by staff)
s� 2nd El 3rd ❑ 41"
What type of temporary sign are you proposing?
/ (check one)
R B,4NNER ❑ PORTABLE
❑ A-FRA.,'VfE
Depending on the zoning district the maximum height of the sign will be
(check one)
[iZ I2 feet if freestanding ❑ 20 feet if on a n all ❑ 30 feet if on a wall
(See 18-4.15.8 - 18-4.15.14)
Depending on the zoning district the required
setback from public street right of way will he
(check one)
Property
❑5fee t ❑10feet
(See 18-4.15.8 - I8-4.15.14)
er's I Agent's Signature
Issued/Approved By
Depending on the zoning district the maximum size of the sign will be
�� (check one)
9 24 square feet ❑ 32 square feet
(See 18-4,15.8 - 18-4.15.14)
Dates you are requesting the sign to be in place.
_thmugh__._q
When entering the dates above, plc&w 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 erection of the sign.
The Ordinance requires the sign to come dawn between permits and
will be approved on -site by a Code Enforcement Officer during
regular business hours only.
A maximum oftwo pennits will be accepted for review for each
establishment at one time.
Date
Date
OFFICE UISE ONLY +, �r ,�Ns— 7 tom_ _
FCC amount 5 ` �J f )„� —
y�_ Date Paid_++#fff heck Ie+ 8y 1l'hn7 Receipt 13v. y . permit
County of Albemarle Department Of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax. (434) 972-4126
q
l 1/1/2015 Page l of I
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning (Yearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
certify that notice of the application,`--y—
[County application name and number] — 1
was provided to (`Lantf— dCL+"j,nc, i2>cJo 0_i a•Yl )
���-_a_..�e��� the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number ►�� $ ` y —by delivering a copy of the application in the
manner identified below:
..—_ 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
Dale
?C— Mailing a copy of the application to �t��L t t :
..i�� 1�� drPm t4ssr�c.�uke;<�r .
[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 r
ofecipient's title or
office for that entity)
on Ito to the following address:
Date
z_��,� o a
_
[address; wrhfert 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.).
a
Signature of -Applicant
Print Applicant Name
Date �-
. s
F � e�5►�5