Laserfiche WebLink
BURNETT COUNTY <br />UNIFORM ORDINANCE CITATION <br />SECTION 66.119(1), WIS. STATUTES <br />STATE OF WISCONSIN <br />THE UNDERSIGNED, BEING DULY SWORN AND UNDER <br />OATH, COMPLAINS FOR AND ON BEHALF OF THE <br />COUNTY OF BURNETT UPON INFORMATION AND <br />BELIEF, THAT ON OR ABOUT, <br />DAY OF WEEK I DATE VIOLATION I TIME ❑ AM COU <br />IC'' - PM <br />NAME LAST FIRST <br />STREET OR ROUTE <br />DEPOSIT PERMITTED B.C. 1 n 0 8 <br />1' 2 .> . F v V <br />CIRCUIT COURT OF BURNETT COUNTY <br />TWP-VILLAGE-CITY <br />MI DATE OF BIRTH AGE <br />— MO. DAY YR. <br />CITY, STATE, ZIP CODE SEX ❑ M <br />$ Forfeiture <br />$ _ Penalty Assess. <br />$ - Court Costs <br />$ J1 - -1. �'0TOTAL <br />❑ F <br />DID UNLAWFULLY <br />ON THE ABOVE STATED TIME, DATE AND LOCATION, THE DEFENDANT (DESCRIBE VIOLATION — STATE FACTS) <br />Y 3i i 4 <br />-Pe crie41 1 1-E'c fsa b `ft <br />ow" <br />in violation of section(s) <br />1 of the ❑ `" Ordinance <br />and prays that he/she may be held to answer therefor. ❑ Burnett Co. ordinance adopting sec. <br />`s - <br />Signature of Officer <br />SUBSCRIBED AND SWORN TO Before me this date 19 Titley <br />s; - <br />,.�_t_ <br />Name Title Department or Agency <br />YOU ARE HEREBY NOTIFIED TO APPEAR IN THE <br />ABOVE NAMED COURT ! <br />,{ THE MAXIMUM FORFEITURE FOR THIS VIOLATION IS $ F <br />C� A.M. � <br />ON T 19 r AT 1- ❑ P.M. THE COURT MAY ALSO REVOKE ALL LICENSES, CONFISCATE ALL EVIDENCE AND <br />BURNETT COUNTY GOVERNMENT CENTER REQUIRE RESTORATION OR RESTITUTION OF ANY ENVIRONMENTAL DAMAGE. <br />