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s b � <br /> SIGN PERMIT APPLICATION— Burnett County, WI G� <br /> f <br /> z <br /> Permit Fees: t <br /> Off-Premise S100 <br /> On-Premise 50 <br /> Directional Off-Premise <br /> *NOTE:After-the-fact(AAhen no ernut is obtained prior to construction)is up to three times the normal fee. <br /> Applicant Complete All Sections Below This Line q� <br /> Property Owner's Name: <br /> c <br /> Property Owner's Mailing Address: C2 GIr A to <br /> City State Zip <br /> Contact's Telephone Number: ��� - G�J"_4+ -Fi eE� (� A <br /> Contact's Email: a3�� <br /> **If staff has a question about this application.you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will acce t emails from the following addre s: (,BurnettCountyWI.gov 1 <br /> Z C5m U% Zg <br /> Legal Description of Property: <br /> Section#: � Town#: N Range#:�W Town of: Spa/-F <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system properti>page. <br /> 355 9 2— <br /> Tax ID#(1-5 digits): <br /> Property Site Address: �mw '1 Y4 <br /> 70 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes <br /> ❑ Off-Premise On-Premise ❑ Directional (Off-Premise) y <br /> Sign Contractor: / ,,e d izzs <br /> 1 <br /> Anticipated Construction Start Date: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r <br /> r/1�}Il Pm/ �iok5 or- lie_ Si'9a � Le; gf_ /�s� 3 t� {�"^ I�i� z <br /> f N <br /> Z, 7�' �e u Ato� arcl ' II c,3 �icG Q a� '(y0 iw t^U1 N bCr O L9/TV1 $/& �j64G • <br /> 5G/1-Z0-0J wqS /10 coNS e = FeeRec: S <br /> ` " <br /> #: 71 Z.Ck -7 <br /> -flea <br /> z <br /> Date of staff site visit: 7 g Z� Initials of sit visit staff: i // _ f ; 7W. <br /> CD U-7; }s <br /> PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE:= �. <br /> o <br /> I Im <br /> Page 1 of 3 J o S <br /> CD C <br /> Burnett County,WI Sign Application —Rev 11/2024 z <br /> g <br /> � loll <br />