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UNIII ORDINANCE CITATION <br /> BURNETT COUNTY SECTION 66.119(1), WIS. STATUTES $ Forfeiture <br /> STATE OF WISCONSIN DEPOSITIER�[TI!D S J B.C. 14 $ 4 $ Penalty Assess. <br /> TWE UNDERSIGNED,BEING DULY SWORN AND UNDER JJ S��iCy� $ Court Costs <br /> OATH,COMPLAINS FOR AND ON BEHALF OF THE <br /> COUNTY OF BURNETT UPON INFORMATION AND CIRCUIT COURT OF BURNETT COUNTY �.�r <br /> BELIEF,THAT ON OR ABOUT, Y TOTAL <br /> AY OF WEEK DATE tVIIOLATION TIME AM COUNTY ILLAGE-CI <br /> YY <br /> PAJ J–409 ❑ PM Ru ILIE i ti/r-/S <br /> NAME LAST F1RS� MI DATE OF BIRTH AGE <br /> GC ALAS Er{U'nr� MO. DAY YR. <br /> STREET OR ROUTE CITY,STATE,ZIP CODE SEX '0 M <br /> 9507 UjouCO(Ap.C+ �S�a��•, ?C Slier,- Gk)s 5-1/0"a ❑ F <br /> DID UNLAWFULLY IA,-J, f. ie' Ci"Srr_.p. 4t7e Tre-',i^,r-'+ S r�M u itl\ut- <br /> OTHE ABOVE STATED TIME,DATTlE AND LOCATION, E DEFENDANT( CRI VIOLATION—STATE FACTS) <br /> HIS ONJrt,tif .�4S�CPC rIJN (�n/415., ��}'0y11+e r �: 0!"C �-yJ�'-(_�f �l/1L-c. <br /> SEy tiw 4 /5 ON IW. I/1{S 1P- /�' )�J4n Yt.4 Lftil k". J rm ( 6 ' 75 <br /> h0t7iher& S>`-wile, t SE'!�� f�c ���cft,, /J'tu�(luG on, fk ru-"T <br /> r <br /> /m(1 cf(IS <br /> lvdice-+e r X)L: All/nil rGy ue [� <br /> '5' Py ur w.r (u,f� '4(" <br /> in violation of seaion(s)— of the ❑ l � � Ordinance <br /> and prays that he/she may be held to answer therefor. ❑ Burnett Co.ordinance adopting sec. <br /> Signature of Officer / <br /> M <br /> SUBSCRIBED AND SWORN TO Before me this date 19 Title G-7` .nj1^�- i/ <br /> / <br /> Name Title Department or Agency <br /> YOU ARE HEREBY NOTIFIED TO APPEAR IN THE <br /> ABOVE NAMED COURT ,SOO, <br /> I H ;?G(l 9 % A.M. <br /> ' n THE MAXIMUM FORFEITURE FOR THIS VIOLATION IS$ <br /> ON �C -M—AT L ❑ 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 />