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u, b con <br /> • SIGN PERMIT APPLICATION-Burnett County, WI a <br /> • <br /> y N <br /> Permit Fees: S c o <br /> a <br /> Off-Premise $100 a <br /> On-Premise h' )DO <br /> Di ectional(Off-Premise) X25Cil <br /> _ , <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 /> �i A o � <br /> Property Owner's Name: Mt/K / 1 717# n/Xt.' �v/'Z &A Ly'!l ► <br /> /� ,g �j r <br /> Property Owner's Mailing Address: /9 05 G (/A--, � t2� 1 -��Ufivf b'k' 574-6 / o a <br /> / City State Zip g <br /> Contact's Telephone Number: 7/..S-- 4' -c-— 77 1 lb <br /> Contact's Email: 1-27/Kd,/7-/J/i,c' e /77s, r C 4"1-1*--7 ° `� <br /> oli <br /> Legal Description of Property: 5r-'r r 4 l AuS-e I <br /> Section#: Town#: N Range#: W Town of: c- <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C ['if <br /> Parcel#(24 digits): f' 7-4 ,7 7 y �1T Pr/( ��((J( r' <br /> Tax ID#(1-5 digits): ) 8/8.61 <br /> Property Site Address; 7 c- 7" (0l.-ti 72c/ l 5, ciftbP,' ric' cN 0. <br /> a <br /> S. <br /> TYPE OF PERMIT(S): Check appropriate box/boxes v <br /> H <br /> ❑ Off-Premise ,On-Premise ❑ Directional (Off-Premise) scn <br /> Sign Contractor: 777 i7 .cj l21- c_v <br /> -s <br /> Anticipated Construction Start Date: ,-3 <br /> 0 <br /> AREA BELOW'THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r <br /> 09 <br /> THIS PERMIT IS SUBJECT TO ALL C NDITIONS LISTED BELOW: W <br /> Sept Ae 5 --/v 6e., tufo `je s©u 8 - ii <br /> so .Ma-- //- of leos71- IZ3 ed fro wt fhe czet-leflii4P, <br /> o-F Coe- kt, Ad A A . 5i' H 7 be_ Y+�ro t it. / h z N 2..o 2,0, <br /> z Fee Ree: G X) <br /> m <br /> r <br /> D <br /> -xi <br /> Date of staff site visit: /fi�7�ea T fJ Initials of site visit staff: /r <br /> < a <br /> PERMIT APPROVED BY LAND SERVICES OFFICIAL: ' ', DATE: 0/2020 72c. Cr. <br /> > me -17 <br /> „ Z._ 511o — <br /> ? 0 nr. 00 <br /> .< eio = <br /> m C N <br /> Page l of 3 n li Z § <br /> Burnett County,WI Sign Application-Rev 1/2020 gOW <br /> �� <br />