Laserfiche WebLink
SIGN PERMIT APPLICATION - Burnett County, WI z z <br /> ., H N <br /> Permit Fees: 0CD 1 <br /> a <br /> Off-Premise $100 C7 0 <br /> On-Premise $50 li <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. i <br /> Applicant Complete All Sections Below This Line <br /> n <br /> W 04 . ,PI. Ppiv&i i Li-c: . <br /> ; <br /> Property Owner's Name: r <br /> Property Owner's Mailing Address: a 1-7 1-1Gv7 3s Li" 77 3NO W S 5 '36 o <br /> / ( City State Zip <br /> Contact's Telephone Number: 7/v— . SI- 31/o <br /> P <br /> � pp ' Ne o <br /> Contact's Email: �� �u�(1'�^ �� � �r �� <br /> Legal Description of Property: a <br /> Section#: gr Town#: N Range#: 4 W Town of: sGui`S S N P <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* < 1 <br /> o , <br /> Ilk <br /> Parcel#(24 digits): N. <br /> Tax ID#(1-5 digits): 3 c{({3 0 <br /> Property Site Address: ^7 /YO /1'Ai A; S/ , c C <br /> o r <br /> TYPE OF PERMIT(S): Check appropriate box/boxes r R <br /> 3 N <br /> ,�` . <br /> ❑ Off-Premise iOn-Premise J Directional (Off-Premise) * cn <br /> Sign Contractor: ` f <br /> -3 <br /> -1 <br /> Anticipated Construction Start Date: o <br /> AREA BELOW THIS LINE,FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED ELOW: Ihr, Fi- <br /> .9 z <br /> r �� �`.T__ `moo ��C c ce ("\ o -� Q� y <br /> S; C_ __. —ra g Q. its- X F41- <br /> 64171-- <br /> , 5_-,D CZ <br /> x Fee Rec: <br /> m 2I %c 1 78'5-92. <br /> Date of staff site visit: Initials of site visit staff:t'�� <br /> PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: Lt- -7- <br /> PERMIT <br /> me 7,0 <br /> CD •• i <br /> (f) 0 C.A.) <br /> Page 1of3 1 <br /> Burnett County, WI Sign Application —Rev 1/2020 2 1 LMS <br />