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Pees: <br /> Off-Premise ....................... SI Computer M: C?-oI4-a-34-It 75-3-o.D-eoo+luu <br /> On-Premise ................... . s 50 <br /> Commercial Directional ... 25 <br /> Q BURNETT COUNTY SIGN PERMIT <br /> Applicant: &_1 O'h Dr)51Lk <br /> Address: -] 39D Fir s'1 - C. Do Y. ova <br /> k)eb51-er ,W:r- SL4113 - Phone#: 715 - 733 -073S, <br /> Property Owner: Pa fr/ c l A-V l Uw <br /> Address: S &V115 GK fir <br /> L�e6S4ev (fir 5y,?93 <br /> Sian Tvne and Location Information <br /> 'type: Off Premise ❑ On Premise Directional ❑ <br /> ��nn <br /> � <br /> Town MeeA'o" Section °9'-GL orlUt(I '/, c50% Property Zoning <br /> Highway Road Name H W V 35 Highway/Road Side N:❑ S ❑ EN W ❑ <br /> Distance from Highway/Road Right-Of-Way J feet <br /> Distance between sign location and nearest road intersection is (JVV feet. <br /> Distance between sign location and centerline of road/highway is 95-. , feet. <br /> Distance from nearest existing off premise sign (off premise sign applicants only) A114 feet <br /> Number of existing free standing signs(on-premise only) <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 we,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> infurntanon contained in this application(including any accompanying schedule)and I further declare that 1 recognize that <br /> this information I am providing will be relied upon by the County ofBitmen Wisconsin in determining whether to issue a <br /> pennit. I further accept all liability which may be a result of the County of Burnett relying on this information 1 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 above described premises at any reasonable time for the purpose of inspection. <br /> Signature Applicant: _ <br /> Property Owner: r <br /> Sion Information Required I((I�r���__ M <br /> Provide sketch illustrating the size(by dimensions),shape and message of sign. D EVE 99 E D <br /> Provide site plan drawing detailing location and positioning on property with reference i nQATto prolyAttyT <br /> I ices, ro, inters c ons,road right-of-ways and existing signs. <br /> ✓� �� A�p, /�l. /3 BURNETCOUNTY <br /> �O <br /> ZONING <br />