Fillable Altavista-Sign-Permit 03-02-2020 Layout 1

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Altavista-Sign-Permit 03-02-2020 Layout 1

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File type: PDF

U.S.A. forms for Town of Altavista

BROWSE TOWN OF ALTAVISTA (VA) FORMS

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BUSINESS/OWNER ESTABLISHMENT NAME:
P
HYSICAL ADDRESS OF PROPOSED SIGN:
P
HONE: EMAIL:
N
uMber of SigNS:
W
ordiNg of SigN:
uSe of SigN:
q
COMMERCIAL
q
I
NDUSTRIAL
q
R
ESIDENTIAL
q
O
THER
Type of SigN:
q
GROUND
q
P
OLE
q
W
ALL
q
P
ROJECTING
q
B
ANNER
q
A
WNING
q
O
THER
SigN MaTerialS:
q
WOOD
q
P
LASTIC
q
M
ETAL
q
N
EON
q
C
LOTH
q
B
RICK
q
M
ASONRY
q
O
THER
Will SigN be illuMiNaTed?
q
YES
q
N
O Will SigN be laNdScaped?
q
YES
q
N
O
diMeNSioNS of The SigN: FT. x
h
eighT of SigN (fT.):
f
or freeSTaNdiNg SigN STrucTureS oNly - SeTback iNforMaTioN (fT.)
Town of Altavista
SIGN APPLICATION
PERMIT NO.
FRONT, FROM THE STREET RIGHT-OF-WAY?
FROM THE PRIMARY BUILDING?
FROM THE SIDEWALK/CURB?
HEIGHT SIGN WILL PROJECT ABOVE GROUND?
NUMBER OF EXISTING SIGNS:
FROM THE RIGHT PROPERTY LINE?
FROM THE LEFT PROPERTY LINE?
FROM THE REAR PROPERTY LINE?
SIGN LOCATED IN THE TOWN RIGHT-OF-WAY?
q
YES
q
NO
q NEW TEMPORARY
REPLACEMENT OTHER:
Multiple Signs?
q
YES
q
NO IF
YES,
PLEASE LIST
ON
REVERSE SIDE.
Town of Altavista 510 7th Street Altavista, VA 24517 Phone: (434)-369-5001 Fax:(434)-369-4369 www.altavistava.gov
All applicants for a Sign Permit must be accompanied by a sketch of the proposed sign(s), drawn to scale showing the
dimensions, height, and design of the sign and sign structure. If any freestanding sign is proposed, a plot plan must be
provided showing the location of all existing and proposed freestanding signs on the lot and all adjacent lots.
Tax Map & parcel NuMber: loT Size (acreS
/Sq.fT.)
curreNT zoNiNg: qR-1 qR-2 qC-1 qC-2 qM
curreNT laNd uSe: qVacaNT qagriculTural qreSideNTial qcoMMercial qiNduSTrial
PROPERTY OWNERS NAME & ADDRESS:
(IF DIFFERENT FROM BUSINESS OWNER)
FT. = ToTal area of SigN (SQ.
FT.)*
SQUARE FOOTAGE OF EXISTING SIGNS:
PROJECTION FROM WALL: ___________________
Sign Permit Fee: $20
FOR COMMUNITY DEVELOPMENT OFFICE USE ONLY
Sketch of Each Sign Attached?
q
yeS
q
No
fee aMouNT:________________
applicaTioN:
q
approVed
q
deNied
zoNiNg adMiNiSTraTor SigNaTure daTe
CONTRACTOR INFORMATION STATE LICENSE NO.:
S
IGN COMPANY/APPLICANT NAME:
ADDRESS:
PHONE: EMAIL:
BY SIGNING BELOW, I CERTIFY I AM AWARE OF THE REQUEST SUMBITTED AND THE INFORMATION PROVIDED IS TRUE TO THE BEST OF MY KNOWLEDGE.
PROPERTY OWNER SIGNATURE DATE
I HEARBY CERTIFY THAT I AM ACTING WITH THE KNOWLEGE AND CONSENT OF THE PROPERTY OWNER AND/OR BUSINESS OWNER TO THE REQUEST DESCRIBED ON THE
APPLICATION
. BY SIGNING BELOW, I AGREE THE INFORMATION PROVIDED ON THE APPLICATION IS TRUE TO THE BEST OF MY KNOWLEDGE.
BUSINESS OWNER/CONTRACTOR SIGNATURE DATE
MULTIPE SIGN INFORMATION
LOCATION & WORDING SIGN DIMENSIONS (FT.) SIGN TOTAL AREA (SQ.FT.)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Town of Altavista 510 7th Street Altavista, VA 24517 Phone: (434)-369-5001 Fax:(434)-369-4369 www.altavistava.gov
Building Permit Required: YES NO
**Campbell County Building Permits and Inspections
| 85 Carden Lane | Rustburg, VA 24588 | (434)-332-9596
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Altavista-Sign-Permit 03-02-2020 Layout 1

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Completed 10 July 2020

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