HomeMy WebLinkAboutTS201600035 Application 2016-06-08Application for
Temvorary�-Sien Permit
[n Temporary Sign Permit = $27
ATTACH A PICTURE OR SKETCH OF SIGN SHOWING DIMENSIONS AND LOCATION ON THE PROPERTY
Name on Sign / Business Name:
Q
Location of Sign / Property: Q y2a n 4o'_
Tax Map and Parcel: 779 ii Zoning:
I
Physical Street Address (if assigned): U� _�z 1 c 11 r+ as -
Applicant/Business Owner (Who should we call/write concerning this project?):/i ) Or r - -A h..,j
Address p �. C i '� 1 ay city � r 1 u $4 11-9 State V"' Zip � ►O�
Daytime Phone :4\� Fax AW a�io1� 11 E-mail �f V
Owner of Record
Please fill out the followinE:
Depending on the zoning district the maximum size of the sign will be
What number permit is this for your business this year?
- -> (check one) (this will be verified by staff)
(check one)
24 square feet El32 square feet
�ISt ❑ 20d 3rd ❑ 40'
(II&JSee 184.15.8 - 184.15.14)
�T
What type of temporary sign are you proposing?
Dates you are requesting the sign to be in place.
(check
J a'- through J
one)
❑ BANNER P1 PORTABLE ❑ A -FRAME
When entering the dates above, please keep in mind the fog
Depending on the zoning district the maximum height of the sign will be
information:
(check one)
12 feet if freestanding ❑ 20 feet if on a wall ❑ 30 feet if on a wail
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.
(See 18-4.15.8 - 18-4.15.14)
The Ordinance requires the sign to come down between permits and
Depending on the zoning district the required
will be approved on -site by a Code Enforcement Officer during
setback from public street right of way will be
regular business hours only.
(check one)
A maximum of two permits will be accepted for review for each
215 feet ❑ 10 feet
establishment at one time.
(See 184.15.8 - 18-4.15.14)
rop ty Own s / Agent's Signature Date
Issued/Approved By Da
OFFICE USE �NLY Vi'Ye31N -t � ,''��/'� T5 2-011u — �
Fee amount �— Date Pai� Check # IMT By Who? Receipt # By: S_� Permit #
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
I IA/2015 Page 1 of I
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,.a ) S ,!� rl
[Codnty application name and number]
was provided to Lam. Cs b' the owner of record of Tax Map
[name(s) of the record own rs of the parcel]
and Parcel Number
mer identified below:
7Hand delivering a copy of the application to
by delivering a copy of the application in the
[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 CJ 1 \3k \ io
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
Z; E SA I? , kA
Print Applicant Name
\k31, �,
Date