HomeMy WebLinkAboutTS201600081 Application 2016-10-26Application for
Tem
Permit
Temporary Sign Permit = $27
ATTACH A PICTURE OR SKETCH OF SIGN SHOWING DIMENSIONS AND LOCATION ON THE PROPERTY
Name on Sign / Business Name:
Location of Sign / Property: n r
Tax Map and Parcel: N <0b — M- CX) Q Qq � Zoning:
Physical Street Address (if assigned):
Applicant(Business Owner (who should ws call/write concerning this project?): 1% rr�p
Address �� o� City State Zipc7Or
Daytime Phone oCgiD 1���Fax # Zq 6 All E-mail J
Owner of Record
Please fill out the following:
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)
(check one) (this will be verified by staff) t 24 square feet 32 square feet
❑ 1„ ❑ 2nd 5"d 4m rr�` (See 18-4.15.8 - 184.19.14)
What type of temporary sign are you proposing?
(check one)
❑ BANNER ❑ PORTABLE ❑ A -FRAME
Depending an the zoning district the maximum height of the sign will be
(check one)
❑ 12 feet if freestanding ❑ 20 feet if on a wall ❑ 30 feet if on a wall
(See 184.15.9 - 18-4.15.14)
Depending on the zoning district the required
setback from public street right of way will be
(check one)
❑ 5 feet ❑ 10 feet
(See 18-4.15.8 - 18-4.15.141
Issued/Approved By
Dates you are requesting the sign to be in place.
® l_; Hugh
When entering the dates above, please keep in mind the following
information:
Each permit for a temporary sign shalt 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 Cc& Enlb=meut Officer during
regular business hours only.
A maximum of two permits will be accepted fvr review for each
estshlishment at one time-
��
Date
Date
OFFICE USeONLY 1, �+,
Fee amount $ i '7� Date Paid -1 Check # 3 By Who? rI ipt # if 11 1 By `Permit on ��_-J&
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
.4rlInMistrator Determinations orAppeaLs, Sign Permits, Building Permits) if the application is nat the
owner:
I certify that notice of the application,
M1
[County application name and number]
was provided to the owner of record of Tax Map
[name(s) of the record owners of the parcel)
and Parcel Number ab - 60. 64�h% by delivering a copy of the application in the
manner identified below:
Hand delivering a copy of the application to 5JO
(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 VbLl\16
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
ifthe owner ofrecord 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 this requitement], estate tax assessment records satisfies
Signature of Applicant
Print APPlicaff Name
t e I1L.
Date