Laserfiche WebLink
UNIFORM ORDINANCE CITATION <br /> BURNETT?COUNTY SECTION 66.1190), WIS. STATUTES $ �J Forfeiture <br /> STATE OF WISCONSIN DEPOSIT PRMI>TED�, B C $ �' Penalty Assess. <br /> THE UNDERSIGNED,BEING DULY SWORN AND UNDER <br /> cs:D�- $ Court Costs <br /> OATH,COMPLAINS FOR AND ON BEHALF OF THE <br /> COUNTY OF BURNETT UPON INFORMATION AND CIRCUIT COURT OF BURNETT COUNTY $ LI u�TOTAL <br /> BELIEF,THAT ON OR ABOUT, <br /> DAY OF WEEK DATE VIOLATION TIME [] AM COUNTY TWP-VILLAGE-CITY <br /> f` <br /> -4 PM <br /> NAME LAST FI STf I DATE OF BIRTH AGE <br /> t1s 71\17 icar�1 ;�� <br /> MO. DAY YR. <br /> STREET OR ROUTE CITY,STATE,ZIP CODE SEX ❑ M <br /> DID UNLAWFULLY q&c <br /> ON THE ABOVE STATED TIME,DATE AND LOCATION,THE DEFENDANT(DESCRIBE VIOLATION—STATE FACTS) 7 .4 <br /> U6 <br /> lei ` <br /> in violation of section(s) of the ❑ !r4 ""' 1 Ordinance <br /> and prays that he/she may be held to answer therefor. ❑ BurnetI Co.ordinance adopting sec. <br /> Signature of Officer <br /> SUBSCRIBED AND SWORN TO Before me this date 19 Title <br /> Name <br /> 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$ <br /> (k1 A.M. <br /> ON ® t9' AT Q 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 />