HomeMy WebLinkAboutTS201700030 Application 2017-05-09Application for MO!"Im,
1 emporary Sign Permit` "
❑ Temporary Sign Permit = S27
ATTACH A PICTURE OR SKETCH OF SIGN SHOWING DIMENSIONS AND LOCATION ON THE PROPERTY
Name on Sign / Business Name: \C
Location of Sign / Property: t 3 �� l oe-yn J L
Tax Map and Parcel:y��i�—��-C�o- , �{� Zoning-. Q�
Physical Street Address (if assigned): 1 JJ 1
Applicant/Business Owner (Who should we call/write concerning this project?): \f I ltr% % n, —
Address �0 a\A
Citylo ,/ JV1 State Zip/
Daytime Phone &134 A kD Fax ii
--E-mail t4_ tl tc_Ac 'y,Q c:.-t • cLv—
Owner of Record
Please fill out the follovvina:
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) (this will be verified by staff)
(cheek one)
❑ 24 square feet 32 square feet
)(21❑ 3re ❑ 4a�
(See 18-4.15.8 - 18-4.1 _ .14)
What type of temporary sign are you proposing'?
Dates you are requesting the sign[o�be in place -
(check one)
_ithrough Lf_-�� ---
❑ 13ANVE:R )(PORTAI3LL ❑ A-F'I2AR1F
When entering the dates above, please keep in mind the Following
Depending on the zoning district the maximum height of the sign will be
information:
(check one)
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 18-4.15.8 - 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
❑ 5 feet ❑ to feet
establishment at one time.
(See 18-4.15.8 - 18-4.15.14)
Property Ow s / Agent's Signature
date
Issued/Approved By
!)arc
OFFICE USE ONLY
fee amount $�7 •d0 Date Pahl 7 Check if >� a By VJho7�Lf... � � Receipt # J�� fay: _ Permit �S 3 ' �"
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 I
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 ap ication ame and number]
J AS�F 1
was provided to � GM. L1 y-L S the owner of record of Tax Map
[name(s) of the record owArl of the parcel]
and Parcel Number _�QO'�W - ( U- 00 - 01\U) by delivering a copy of the application in the
manner identified below: �(
Hand delivering a copy of the application to ` �S-� �� ,�`�cl C. CWS
[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]
Oil 1� _
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 to the following address:
Date
[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].
*Sinature pplicant
Pri tAp licantName
�1 jj_j_
Date
--A: 47
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