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0 C, lg PM CLOVER ririlt,, ErNA4CE INC- 4 4 W9 <br /> 16'.32 BjRHCTT C004TY GOO CENTER <br /> compvtor 0: <br /> ofl.prtmlst...................... SAO I <br /> K' s <br /> ..................... <br /> S 2 <br /> L---------- <br /> BURN 0jjNTY SIQN PERMIT <br /> 111ar Y, <br /> Applicant: <br /> �cl <br /> k0 E_%_� <br /> Address: ,�j -715-- '? <br /> Phone 4: <br /> —4-1 <br /> Owner: 7 J <br /> Property <br /> Address: <br /> ;)q90 <br /> 11 as� <br /> Lot U. <br /> Type: On Premise p Directi.onal C3 <br /> vJ 1/. Pro rtyZolling'—Y� <br /> AQ orSecion <br /> Town t <br /> Hishwayffload Side <br /> Iiishway Road Name <br /> feet <br /> Distance from klighway/Mad Right-Of-%VaY <br /> feet from centerline of <br /> d nearest-toad ltters'eWon (OLL— <br /> Distance between sign HOCRT i On's n <br /> road/highway. <br /> feet <br /> 4 premise sign applicants 0111Y) <br /> Distance from nearest existing rff premise Sign (!)ff� ._1C__ <br /> Nuinber of existing rcce standing sit1lig (con-premise only) __L ... <br /> Of <br /> eXa»d <br /> ed byTne and XO the bc&t^y1rig scbe )M3 beenI and accufacY Of a,,.1pplic, ibIc for the de,.F talgi I recogrii?.c thatI decial,t1latOtis. Ition(i;jcluding any accovn�anI acknowcd9c 111AI I zm esl;.noNvIedSe&nd belief it Is true,cOrtect and complotZ. . sthedul ) further d.claycI). ccomln. n9l i I ining whether to issue a <br /> inforInallon contajjlCd in twg Application(including at tile County of 13urllert Wi5co 11 A deterrn j1Lr()rMatIorj I an,providirtr <br /> Ulis irsom%aWn I am providing will be rclied upon by sulk of Ile County of Burnett rely-ng OR d U <br /> permit. I further 2=0 All llal)'I't).which <br /> r,.iay be a re bdmir�isl.Cdr19 county Ordinance r r auti%orize <br /> in this applicau0n. I agree to permit County orrlci�tls cllargcd with <br /> person to have access to the above escribed pm.mi;cs tit any rcAson.ible UITIO ror the Purpose/01f <br /> Signature App <br /> Prove(l), Owner. <br /> 1AInform mx <br /> h (1)� d1rn0ns'o1)s)' shape Find message of siFn I <br /> rlovijc sketch,illustrafinD t 0 size. distances to property <br /> ng on promcrly with rcf"eneed <br /> pluvido site�pjart drawing detailing 10�;-atiOn and PsitiOni <br /> existing signs v <br /> road 62,bt-Qf-Ways andTOld iwL:rsecti_un,1s, <br />