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TS201700002 Application 2017-01-10
Application for Temporary Sign Permit APPLICATION REQUIREMENTS: Temporary Sign Permit = $27 A picture or sketch of sign showing dimensions and location of sign on property must 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: Martha Jefferson Family and Walk -In Care Location of Sign / Property: Above main suite entrance on South side of b Tax Map and Parcel: 076M 1 -00-00-00200 zoning: PD-SC Physical Street Address (if assigned): 435 Merchant Walk Square, Suite 400, Charlottesville, VA 22902 ApplieantBusittess Owner (Who should we call/write concerning this project?): Gropen, Inc; Tanya Rutherford Address 1144 East Market St City Charlotteville State VA Zip 22902 Daytime Phone (434) 295-1924 Fax # 434-295-1926 E-mail tutherford@gropen.com Owner of Record Venture Property Please fill out the following: What number permit is this for your business this year? ryo ck one) (this will be verified by staff) �lJ �151 ❑ 2•d ❑ 3rd ❑ 41h ❑ 5th ❑ 6rn What type of temporary sign are you proposing? (check one) BANNER ❑ PORTABLE ❑ A -FRAME Depending on the zoning district the maximum height of the sign will be (check one) ❑ 12 feet if freestanding 17120 feet if on a wall W 30 feet if on a wall The required setback from public street right of way will be 5 feet Property Owner's / Agent's Signature Issued/Approved By Depending on the zoning district the maximum size of the sign will be ❑ 24 square feet © 32 square feet Dates you are requesting the sign to be in place. iI GC COCOtbrough dLAn 1 11 if12-b'7 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, • Please note that an establishment is not permitted more than sixty (60) days of Zoi Date OFFICE USE ONLY 15 Fee amount $ Date Paid Check # 35 By who? Receipt # � By: �— Permit # County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 11/02/2015 Page I of I Cn C7 w O m � II � N C, O O Z fJ W D = z z ►r m O m 0 m Q O g 0 C z Orri d Ga _ C %i O Z X IV m N W � z O � Z y ch O Dm El O r O � 0 r m i m O➢ T/ O y d -/ O O D o (wJ d A V Ci O gym- o T N d 0 W W A G N % y � � O_ O END I N a O O H W s a aCS O 1— oc/i W tz V) O CL O u O O CL