HomeMy WebLinkAboutTS201600075 Application 2016-09-22Application for
Temporary Sign Permit
APPLICATION REQUIREMENTS:
❑ Temporary Sign Permit = $25
❑ A picture or sketch of sign showing dimensions and location of sign on property most 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:
Location of Sign I Property: l U 3 � 0 % f
Tax Map and Farrel: �" ! 2f4 Zoning: y't
Physical Street Address (if assigned): � CZ 3 16
k- - /l
ApplicantfBusiness Owner (Who should we cdywite eo®cerning this project:
Address
CitytZ�"l.; L4 State 1J Zip
# E-mail d ^J Gfl
Daytime Phone f �y
Owner of Record it r
What nurnber permit is this for your business this year''
(check one) (thus will be verified by
staM
3f° 0q�
s' are you proposing?
What type of temporary c� k one)
Depending on the zoning district the maximum size of the sign mill b
`f 5-24 square feet ❑ 32 square feet
b, DaW you W requesting the sign to be in place-
❑ 6 )S4,
—�--
BANNER ❑ PORTABLE U!�A FRANYE
Depending on the zoning district the msximnm height of the sigm will be
(check one)
2
12 feet if freestanding 0 feet if on a wall ❑ 30 feet if on a wan
aired setback from public street ri�tt of way win be
The req
5 feet _.-
Property
n ` ! Agent's Signature
When entering the dates above, please keep in mind the farrowing
information= be valid for a period
Each permit for a temporary sign after the erectio
not to exceed fifteen (15) consecu hvo da days
of the sign. come down between
The Ordinance
requires the sign
• permits and will be approved on -site by a Code
Enforcement officer during regular business hours only
• A magnum oftwo p
er6ts will be weepted for review far
each establishment at one time.
• Please note that an establis 6(fent i s of
ermined more than siz
__. ;n a calendar VC--
Date
IssuedlApproved Bly �(D— 7
1 l4 Permit #
OFFICE Ur- ONLY paidQ l0 Check# U By Who MG, Ll�
Fee amount S Daft�ng�. rJn
County of Albemarle DeQartment of Community Development
401 McIntire Road Charlottesvine,
VA =902 V01W- (434) 296-SM Fax. (434) 972-4�6
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) if the application is not the
owner.
I certify that notice of the application, /, 6,4— r-,L - ' Y t 5 /"/ /
[County application name and number]
�c was provided to �2d C (y the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number ( % "-c delivering a copy of the application in the
manner identified below:
_v,"' Hand delivering a copy of the application to .'�f7� %�7 C•t�
[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 f� 16
Date '+
�.rt� R
Mailing a copy of the application to t V 1 fyA U �z (—
[Name of the re�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]
on1_� �� I b 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].
Sigma 6f pplicant
Print Applicant Name
lfL�
ate /
r..
Location of temp
sign
Camryn Limousine application for temporary 15 day road sign
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