HomeMy WebLinkAboutTS201600048 Application 2016-06-17Application for
Temporary Sign Permit
LICAUON REQUIIZEMENTS: �.
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 awlicant.
Name on Sign / Business Name: T; i t J ,r (( S
Location of Sign / Property: V P U"-\-Vv
Tax Map and Parcel: 0 ) J - 0 C . c} ,j - 0 l 1 i)
Zoniitg:
Physical Street Address (if assigned):
v , IL, 0 c, 2- 2 c}
Applieant/Business Owner (who should we cAlhwite aoncaning this project?): �+n S
Address 9 L2V 112) City (.c � }
J LL ,--C � State V u Zip Z Z q `f
Daytime Phone �{'�`�► 4 (1 --'- S1 L t. Fax # -'@
E-mail_l (Ad(A GeVu-iLV4d4�C. ryWq , ya,Ef-
Owner of Record
What number permit is this for your business this year?
(check one) (this will be verified by staff
t. - ❑ z•a ❑ Y4 ❑ 4- ❑ 5m ❑ 61e
What type of temporary sign are you propodng?
&ANNER
(check c ae)
❑ PORTABLE ❑ A -FRAME
Depending on the zoning district the maximum height of the sign will be
`,� (check one)
�L! 12 feet if freestanding ❑ 20 feet if on a Wall ❑ 30 feet if on a ,,all
The required setback from public street right of way will be
5 feet
/ Agent's
By
Depending on the zoning district the maximum size of the sign will be
❑ 24 square feet X32 square feet
Dates you are requesting the sign to be in place.
When entering the dates above, please keep in mind the following
information:
• Each permit for a temporary sign shall be valid for aperiod
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 far review for
each establishment at one time.
• Please note that an establishment is not
ipermitted more than jh ty (60) days of
OFFICE U� ONLY Lin 0.
Fee amount S '1 ' to -
Date Paid & i311b Check # 8-V 1 By who? RO n n; e. Receipt # 101'96g By. F--Q Ppmit # il
4 D
- IS-1 . - I - i4
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
4/26/2012 Page 1 of 1
W ^)
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 orAppeals, Sign Permits, Building Permits)
owner. if the application is not the
I certify that notice of the application, � � �
[County application name number i
was provided to (A)0j6&64KROrd r -in-c) the owner of record of Tax Map
[name(s) of the record ownefs of the parcel]
and Parcel Number D Z d-y w- ,,yy
manner identified below: _b3' delivering a copy of the application in the
- 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
Date
` Mailing a copy of the application to W .)3 pir � LO
�
r✓1.� rr1 J
[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 t�, to the following address:
Date
[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].
�r1
Signature of Applicant
Lp- 4.r_.
Print Applicant Niarne
Date
I
IF