HomeMy WebLinkAboutTS201600091 Application 2016-12-09Application for
Temporary Sien 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 f , �rn�s TC.e_e
Location of Sign / Property: ► f_�, S Se an : naie 1 G r� /
Tax Map and Parcel: �l r,i 7_ — /� _L Zoning:
Physical Street Address (if assigned):
Applicant/Business Owner (Who should we call/write concerning this project?): 1 �; c 1J P� �✓1 v , ,
Address I c, , ,, ,) nC c % City (h, �; �� State L.,,/) Zipa j
Daytime Phone 013'y Fax #
Owner of Record 2 o a ;fry, 4; e�
Please fill out the followine:
What number permit is this for your business this year?
,(,check one) (this will be verified by staff)
llwt ❑ 2.d ❑ 3ra ❑ 4th
What type of temporary sign are you proposing?
(check one)
e] BANNER []PORTABLE ❑ A -FRAME
Depending on the zoning district the maximum height of the sign will be
(check one)
El 12 feet if freestanding ❑ 20 feet if on a wall ❑ 30 feet if on a wall
(See 18-4.15.8 - 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 - 18-4.15.14)
Property Owner's /Agent's_Signature
Issued/Approved By
E-mail j2r� i_tr�,1t c.n�S rir� t�(OMCc st ✓let
Depending on the zoning district the maxim m s' a of the sign will be
(check one)
El24 square feet 32 square feet
(See 18-4.15.8 - 18-4.1 . 4)
Dates you are requesting the sign to be in place.
through 1 d, - r S
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 will be accepted for review for each
establishment at one time.
Date
Date
OFFICE USE ONLY 1U
14
Fee amount $ J}. t"c" Date Paid O J Check # By Who?0rcohV'eC6fi eceipt # MOW By: Permit.. nN
County of Albemarle Department of Commuili{`y`"DeveIopment
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
1 ]/1/2015 Page I 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 or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application,
was provided to
[County application name and number]
[name(s) of the record owners of the parcel]
and Parcel Number
manner 'dentified below:
marine
deliveringco of a copy the application to
the owner of record of Tax Map
by delivering a copy of the application in the
[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
Date
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