2001/07/09 - LAND USE - SGN - On-Premise - S3-2001

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Fees: / /1 Off-Premise ....................... $100 0&p Computer#: I q0D On-Premise ....................... $ 50 16 Commercial Directional ... $ 25 / BURNETT COUNTY SIGN PERMIT Applicant: 1 I .a:s+ Address: 7 l7 w Qc /-::�_4 .e Phone #: � C-� • S — Property Owner: Address: Sign Type and Location Information / Type: Off Premise ❑ On Premise CK Directional ❑ Town s dew Section p GL or (1 f`. '/4 N E '/4 Property Zoning�, f Highway Road Name d _Highway/Road Side N ❑ S ❑ E ❑ W [Z Distance from Highway/Road Right-Of-Way 25 feet Distance between sign location and nearest road intersection '3>S_ feet from centerline of LLnad/highway. Distance from nearest existing off premise sign (off premise sign applicants only) _ } feet Number of existing free standing signs (on-premise only) n I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all informaiton contained in this application(including any accompanying schedule)and I further declare that I recognize that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am providing in this application. I agree to permit county officials charged with administering county ordinances or other authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. Signature Applicant: Property Owner: 1..Jr o cA Sign Information Required Provide sketch illustrating the size(by dimensions), shape and message of sign. Provide site plan drawing detailing location and positioning on property with eferenced distances to property lines,road intersections,road right-of-ways and existing signs.