HomeMy WebLinkAboutTS201600061 Application 2016-09-22A
Application for
Temporary Sign Permit
ElTemporary Sign Permit = $27
ATTACH A PICTURE OR SKETCH OF SIGN SHOWING DIMENSIONS AND LOCATION ON THE PROPERTY
Name on Sign 1 Business Name:, s) C / "- &jc
Location of Sign 1 Property: 7— Q 0
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Tax Map and Parcel: -g.,?lt}/ Ir?fl -
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S/ad Zoning: (�. e!70'i'0i
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Physical Street Address (if assigned):
Applicant/Business Owner (Who should we call/write concerning this project?): -&c-- sci A Za,rw .--0
Address city -_ State�Zip = 7 tom ,
Daytitrt_ Phone CVW - 30 Fax # 1;-mail .Ala rr�5u ram= dl £,1®�
Owner elr Record 'v • -. Ize
What number permit is Us for your business this year?
(check eac) (this will be verified by stag
�ra ❑ 31d ❑ 40
What type oftomporary sign arc you proposing?
(check one)
Q/RANNER ❑ PORTABLE ❑ A -FRAME
Depending on the zoning district the maximum he;ght of the sign will be
(check one)
B 12 feet if freestanding ❑ 20 feet iron a wall ❑ 30 feet if on a wall
(See 184.15.8 - 184.15.14)
Depending on the zduing district the required
setback from public street right of way vrill be
(check one)
95 feet ❑ 10 feet
(See 184.15.8 - 184.15.14)
Property Owner's / Agent's Signature
Issued/Approved
Depending on the zoning district the maximum size of the sign wi.1 be
(check one) ,�,M�
[� 24 square feet *32 square feet
(See 15-4.15.8 - 18-4.15.14)
Dates you are requesting the sign to be in place.
_ 2
through Ilyll
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 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 -,rill be accepted for review for each
establishment at one time.
Date
Date
OFFICE; U �^
Fee dwoiae Paid Check #
By Who
`
Receipt #�Q By Fermit #
amount $ L�(C _�'
_,__•••
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5532 Fax: (434) 972-4126
11/1/2015 Page 1 of I
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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) ifthe application is not the
owner.
I certify that notice of the application, 10e) J sJ 04 v Ht-7 :=
[County application name and number]
was provided 'do ��.sc L>•!�>-> t („' � i2 &,i f z-Us'i the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number by delivering a copy of the application in the
manner identified below: _
1Jc- L /.yyy) �.
Hand delivering a copy of the application to k lc-o�,d7a ;, f[..e. ��->tir,� � , ie ( r :�1y L Ra 031 Azo,t4
[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 ^
cg,/v//(P
Date