HomeMy WebLinkAboutTS201700038 Application 2017-06-09Application for
Tempc>'rar_1Sign .Permit
ATTACH A PICTURE 01.2 SKETCH OZT
(;N SHOWING ING D arY Sign Permit = $27
DIMENSIONS AND LOCATION ONTHE PROPERTY
Name on Sign / Business Name: 1
sckci'c
Location of Sign / Property: ,�. s
T-ax Map and Parcel: tj t-/
l zoning
Physical Street Address (if assigned):
Applicant/Business Owner 0-Vilo should we callhrrnc concernutg this project?) "-4 y— --J
Address --_-_._._,-------___-
-�Y— a M !y,00 S City 1+e5 Ut 11 e- State U' Z, i
Daytime 1 hone �� p `Z 0 3
�L-1 - `� 3 - 7 l9 I:ax N q 01
E-mail_CU_LlSt 331v
Owner of Record ---- -- —
1 What number permit is :his for your business this year?
,check one.) (this will be verified by staf-0
cjs' [) 2nd Q 3rd ❑ Wh
What type oftemporary sign are you proposing?
����
(check one)
2441 ,NEI2 ❑ PORTABLE
A- FIR AYIE
Depending on the zoning district the maximum height of the sign will be
�/ (check one)
f 12 feet if freestanding CJ 20 feet if on a wall
D 30 feet if oil a null
(See 18-4.15.8 - 18-4.15.14)
Depending on the zoning district the required
setback frarn public street right of way wtill be
(check one)
Property
❑ 5 feet ❑ 10 feet
— (See 18=4,1 i.8 - 18-4.15.14)
er's / Agent's Signature
Issued/Approved By
Depending on the zoning district the maximum size of the sign will be
�� (check one)
l)d24 square feet ❑ 32 square feet
(See 18-4.IS.R - 18-4.15.14)
Dates you are requesting the sign to be in place.
through_.. LY)O AJ;,
When entering the dates above, please keep in mind the following
information:
Each permit for a ternporary 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
::-ill 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
establishinent at one time.
Date
Date r
OFFI(--_�F USE pN�LY -- ------._----
Fee amount S Date Paid ------ - —� -
- _--- Check t1 -- --- 0> ta'ho?-_— 5 s2-01
County of Albemarle Department of Community Development
— le n ta_ -
401 McIutir'e Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
1 1/1/2015 Page I If I
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13 a d
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, L�rYI �t? rc�
[County application name and number]
was provided to C _ the owner of record of Tax Map
[narne(s) of the record owners of the parcel]
and Parcel Number _ e� - __ _by deliver'
manner identified below: ng a copy of the application in the
-- —
Hand 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
Mailing a copy of the application to� iZ� ��rrt &Sp( 1,,5 �� L3 �C
[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]
°tt--�--j_ Z
Date to the following address:
_3 1 y
[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 1- ---
Print Applicant Name
r
Date --- �—