Laserfiche WebLink
UNIFORM ORDINANCE CITATION <br />BURNETT COUNTY SECTION 66.119(1), WIS. STATUTES <br />STATE OF WISCONSIN DEPOSIT PERMITTED B.C. 1539 <br />THE UNDERSIGNED, BEING DULY SWORN AND UNDER <br />OATH, COMPLAINS FOR AND ON BEHALF OF THE <br />COUNTY OF BURNETT UPON INFORMATION AND CIRCUIT COURT OF BURNETT COUNTY <br />BELIEF, THAT ON OR ABOUT, <br />DAY OF WEEK DATE VIOLATION TIME ❑ AM COUNTY_ TWP-VILLAGE-CITY <br />❑ PM <br />NAME LAST FIRST MI DATE OF BIRTH AGE <br />A r L MO. DAY YR. <br />STREET OR ROUTE CITY, STATE, ZIP CODE SEX ❑ M <br />ifs t <br />DID UNLAWFULLY <br />ON THE ABOVE STATED TIME, DATE AND LOCATION, THE DEFENDANT (DESCRIBE VIOLATION — STATE FACTS) <br />$ Forfeiture <br />$ Penalty Assess. <br />$ Court Costs <br />$ TOTAL <br />et - <br />in violation of section(s) ` of the ❑ Ordinance <br />and prays that he/she may be held to answer therefor. ❑ Burnett Co. ordinance adopting sec. <br />Signature of Officer <br />SUBSCRIBED AND SWORN TO Before me this date 19 Title <br />Name Title Department or Agency <br />YOU ARE HEREBY NOTIFIED TO APPEAR IN THE <br />ABOVE NAMED COURT <br />❑ A.M. THE MAXIMUM FORFEITURE FOR THIS VIOLATION IS $ <br />ON 19—AT— ❑ 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 />