HomeMy WebLinkAboutTS201600098 Application 2016-12-09Application for
Tempera
Sign .1'ermit
'remporary Sign Permit =
ATTACH A PICTURE Oil SKETCH OF 27
SIGN SHOWING DIMENSIONS
` AND LOCATION ON THE: PROPERTY
Name on Sign / Business Name:
Location of Sign / Property: --------
Tax Map and Parcel: tj t
'`' ------ Zoning:
Physical Street Address (if assigned):
Applicant/Business Owner (bt'ho should we call/write concerning this project?),
Address—.�Y�a- �_LV LC ---------------------
-- rylnlv"7J City=hU�i' lt.� ±�tPSU;IIE_ State U'!4 Zip
Daytime Phone L.��) v�.� � — „1, % �Cfi Fax u �_-3 --O 1 t --
--Ir1 E-rnail�ic�tS 334, �.-
Owner of Record
�aac ,ur uu[ the ronowrn
What number permit is :his for your business this year?
check one) (this will be verified by staff)
�d
2 I] 3!a
What type of temporary sign are you proposing?
(check one)
C✓fB.-t.NNEI ❑ PORT.ABL.F ❑ A-FRANIF
Depending on the zoning district the maximum height of the sign will be
� (check one)
110 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 he
(check one)
5 feet ❑ 10 feet
(See 188-4.15.8 - 18-4_15_14)
Property Owner's / Agent's Signature
Issued/Approved By
Depending on the zoning district the maximum size of the sign %�lll be
�� (check one)
Q"24 square feet ❑ 32 square feet
(See 18-4.15.8 - 18-4.15.14)
Dates you are requesting the sign to be in place.
rough _ otj_
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 rnaximurn of two pc-rmits will be accepted for review for each
establishment at one time.
L1D'
OFFICE }IFF I ) pDJL y -----------�/ —
Fee amount S— _Uate Pa;
Check tl �— (3) \dlhn, -O
— /�_�li�4�cccrpt
C.Pcrrnn N
ot rnty of Albemarle 7J
Department of Community Develo ent — 1
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 24-5832 Fax: (434) 972-4126
11/]/2015 Page I )t 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) if the application is not the
owner.
I certify that notice of the application,
[County application name and number)
was provided to G the owner of record of Tax Map
[narrie(s) of the record owners of the parcel]
and Parcel Number _-!2-e� L _ by delivering a copy of the application in the
manner identified below:
Band 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 - ---- --- ------
X_ Mailing a copy of the application to ��_L ja _tZ� is e�Prr1 uA-e_5 r C: 3 iZc
[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 _1l �� — to the following address:
Date
_3_19i--Lck-SiJC.hers�^_�c,r,10 vt)I�zV(� 10�. _
[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 '--