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SIGN PERMIT APPLICATION — Burnett County, WI <br />Permit Fees: <br />Off=Premise $100 <br />On -Premise $50 <br />Directional (Off -Premise) $25 <br />*NOTE: After -the -fact (when no permit is obtained prior to construction) is up to three times the normal fee. <br />Applicant Complete All Sections Below This Line <br />Property Owner's Name: -uCtra 1uc+ v V, lic . L LC_ (ow L Ix <br />y�Ye.I <br />,t <br />Property Owner's Mailing Address: (�j l 0 t LG h 2. {' �Q�1 �rLQ, 1 Sti7� <br />City State Zip <br />Contact's Telephone Number: � / S- 45 3 - �k L05 <br />Contact's Email: -"V,bo--t-, I e )%C, ". cxyh <br />,VW1 <br />Legal Description of Property: & 9) <br />Section #: ;,O Town #: N Range #:- �� W Town of.0-9."IfIve <br />*Attach additional page if needed for lengthy description OR attach a copy off the deed OR attach tax system property page. <br />Parcel # (24 digits): � �� �>0 T`0 `i"C7 20 ' J p_ , 9n- o " <br />Tax ID # (1-5 digits): -{p�� <br />Property Site Address: 2 D /S7 <br />TYPE OF PERMIT(S): Check appropriate box/boxes <br />❑ Off -Premise ❑ On -Premise ❑ Directional (Off -Premise) <br />J / <br />Sign Contractor:�%lG fGiG�� / //a�/Y��l ��/ ��'i�G`�'�/�C� LLC <br />Anticipated Construction Start Date: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT O ALL CONDITIONS LISTED BELOW: <br />t 1 q I ® 7 Gt 2, 5 P S <br />- 'F do e.,S !Nl e- y-o a se , <br />► ` -051W e YW q a� h S/ <br />Date of staff site visit: S ( Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: <br />Page I of 3 <br />Burnett County, WI Sign Application — Rev 1/2019 <br />2 <br />N <br />�1 <br />A <br />z <br />16 <br />AN <br />52 <br />9-41 <br />� <br />Fee Read <br />s� <br />IV <br />CO <br />O <br />cm <br />