Laserfiche WebLink
5i6n1 P m'�-r s6n/- is--off <br /> Fees: <br /> Off Premise ....................... $100 PIN# �7°t—03—nj-0 La� <br /> On-Premise ...................... $ 50 <br /> Commercial Directional ... $ 25 <br /> BURNETT COUNTY SIGN PERMIT <br /> Applicant: V1 G'TOlZ`, <br /> Address: �` S7 ice- �Z 6 .35 <br /> C <br /> `D+k Q btik�" ; W1 S`(S 3 0 Phone #: <br /> Property Owner: ?P t W1 t kyA, ?Pzo P e-R C— S <br /> Address: P O . &&Y- ;2 6 $ <br /> E��s�.1o2 Wi <br /> Sign Type and Location Information <br /> Type: Off Premise ❑ On Premise K Directional ❑ L4�rr I OSM V 0 P. <br /> Town �(N /SS Section GL or /, I,V1 <br /> � '/4�'/4 Property Zoning <br /> Highway Road Name ST -1-W R () � (�_ Highway/Road Side N ❑ S ❑ E 9 W ❑ <br /> Distance from Highway/Road Right-Of-Way CJS feet <br /> Distance between sign location and nearest road intersection is feet. <br /> Distance between sign location and centerline of road/highway is feet. <br /> Distance from nearest existing off premise sign (off premise sign applicants only) feet <br /> Number of existing free standing signs (on-premise only) 2 <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> informaiton contained in this application(including any accompanying schedule)and I further declare that I recognize that <br /> this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a <br /> permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am providing <br /> in this application. I agree to permit county officials charged with administering county ordinances or other authorized <br /> person to have access to the ab ribed pr mises any reasonable time for the purpose of inspection. <br /> Signature Applicant: <br /> Property Owner: �! <c/`( UL� - t (A <br /> Sign Information Required ECEISE <br /> Provide sketch illustrating the size(by dimensions), shape and message of sign. MAR 112015 <br /> Provide site plan drawing detailing location and positioning on property with referenced di8lafRNE1P7o0 1NTy <br /> lines,road intersections,road right-of-w,ays anti existing signs. ZONING <br /> //;;f e co'n 4 ;4eq 2 S &A--- <br /> APPROVED BY: <br />