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sn <br /> SIGN PERMIT APPLICATION — Burnett County, WI <br /> N y <br /> Permit Fees_ _ <br /> Off-Premise 5100 <br /> On-Premise 550 <br /> Directional Off-Premise) S25 <br /> *NOTE:After-the-fact when no permit is obtained prior to construction)is up to three times the normal fee. \ 0 <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: / p4oe )06t-e-4, <br /> Property Owner's Mailing Address: e[r1S14 .STS <br /> �J "/ , City State Zip f <br /> Contact's Telephone Num��b��er:, 7)r,- ^F4 -7dp-�r`�ye <br /> Contact's Email: 0*4r <br /> .f <br /> ne - G/W� -� (� (�� <br /> Legal Description of Property:_W �v2 7 0.F SS,_ 's� <br /> Section#: Town#: _ N Range#:_ W Town of. <br /> w .a <br /> *Attach additional page if needed ror le ngthv description OR cutach a copy of the deed OR attach tax rvstem property page.* 2 <br /> �w o�d 2- 35- I�- � 3 3- �0� y� <br /> Parcel#(24 digits): e � <br /> �/ tJ <br /> Tax ID#(1-5 digits):_�ll'/ <br /> asa�8 -� �2l <br /> Property Site Address: Tr c °o t <br /> 0 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes o t <br /> y. <br /> ❑ Off-Premise 40n-Premise ❑ Directional (Off-Premise) <br /> Sign Contractor: DG+ ✓��� 1J <br /> Anticipated Construction Start Date: <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ry d <br /> — Ail s muS m ;41� <br /> V19aCL Y'r1nf— m� — !.� � t✓Jpt,�S Bet � � G <br /> V <br /> Fee Rec:MiM <br /> y <br /> O <br /> rn <br /> N <br /> O <br /> z <br /> staff <br /> Date of stasite visit: Q_ C� 3� 7 Initials of site visit staff:_ _ a <br /> a <br /> PERMIT APPROVED BY ZONING OFFICIAL: / DATE:j3� J7 _ o M c <br /> C. <br /> Nm <br /> �SleyvLUK �� 0-,11� z0 C <br /> (' Page 1 of-3 o p Q <br /> Burnett County, WI Sign Application-Rev 1/2017 <br /> ctj <br /> rn V <br />