HomeMy WebLinkAboutTS201600072 Application 2016-09-22Application for
rA�,�wi ri • r • .
-temporary Sign Permit
Temporary Sign Permit = $27
ATTACH A PICTURE OR SKETCH OF SIGN SHOWING DIMENSIONS AND LOCATION ON THE PROPERTY
Name on Sign / Business Name: L : +Re Cimscus T'
Location of Sign / Property: 6�a e�S �naCG
Tax Map and Parcel: Crime "� " 7D Zoning: PJ�,IG
Physical Street Address (if assigned):
Applicant/Business Owner (Who should we calllwrite concerning this project?): M a' • ` 6"C( I
Address `P2 %,y W's City aL.&syllt
Statey A Zip 2ZttoZ
Daytime Phone I) jbL`_74Ct7- Fax #/ E-mail tALU f0nb5 CQCAP�tAtAST. N
Owner of Record TC Ak.t S Sne`t,N Ct•r�keC LLG
Please fill out the followin¢:
What number permit is this for your business this year?
(check one) (this will be verified by staff)
1I4ljn Zed ❑ 3rd ❑ 4th
What type of temporary sign are you proposing?
(check one)
%BANNER ❑ PORTA13LE ❑ A -FRAME
Depending on the zoning district the maximum height of the sign will be
(check one)
Depending on the zoning district the maximum size of the sign will be
(check one)
❑ 24 square feet IZ32 square feet
(See 184.15.8 - 18-4.15.14)
Dates JJyou are requesting the sign to be in place.
Z b`� b through tit) (1ti i D
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
%12 feet if freestanding ❑ 20 feet if on a wall ❑ 30 feet if on a wall exceed fifteen (15) consecutive days after the erection of the sign.
(See 184.15.8 - 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
N5 feet ❑ 10 feet establishment at one time.
(See 184.15.8 - 18-4.15.14) Af
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Property Owner's / Agent's Signature pate
4711
Issued/Approved By Date
OFFICE USLONLY �y ] ` _T5 aOI tr
Fee amount $ r • a� Date Paid 3 �c0 Check#a.0, By Who? _S Receipt # IOUU�By: � — Permit #
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
11/1/2015 Page 1 of 1
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.
1 certify that notice of the application,
[County application name and number]
was provided to IC s JA.V V.n, Cc Acr (,t the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number a'7 rsv a� a l'7 i� (� 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
Date
+ 0
X Mailing a copy of the application to &te�� Bske�.\ KA, Cyr
[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 $ �� r �� _ to the following address:
Date
'ra 3,%-x =2. t , G�,..,L��b.a; tit. VAS zzti-b5
[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 o Applicant
E:�M(I _
Print Applicant Name
Date
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