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SIGN PERMIT APPLICATION-Burnett County, WI <br /> ., <br /> It Permit Fees: CD N <br /> Off-Premise $1 a <br /> RI <br /> On-Premise c $50 ) �' �f( <br /> Directional(Off-Premise) $25 :"..-1'--.D . <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> m <br /> Applicant Complete All Sections Below This Line 7 <br /> 3 <br /> Property Owner's Name: l''`�t (ha_i✓l 4 PC r r H © e,hz <br /> 0 <br /> Property Owner's Mailing Address: 1 z e_cod i)' ul r co 1 S-4(20 <br /> City State Zip <br /> Contact's Telephone Number: S` 4 Up. --r .)._ (� <br /> r .. .: ,___, <br /> Contact's Email:-blitz K.a-..e.ltc,@ ( yytA , L 1 0 z <br /> Legal Description of Property: F. /DO I S0..) 5' ) OP <br /> Section#: D t Town#: Y1 N Range#: 1 W Town of: -.1:311-- n ) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* < <br /> Parcel#(24 digits): d - ( t.-4 ?) -? -114-6 I -3 0'y-&ci - 0 1(coo O <br /> Tax ID#(1-5 digits): 1 ')`S5`CC IIP <br /> � b <br /> Property Site Address: 13D2 (_t,�j"i{L 1 .PA 4 . 500 'r- L -1 S i Q9C`s oN °0 , <br /> 7 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes o <br /> 5. <br /> ❑ Off-Premise ,On-Premise U Directional(Off-Premise) <br /> cn <br /> Sign Contractor: D/ 40 sL1�.4 <br /> 202 Z I x <br /> Anticipated Construction Start Date:3e '- 26f <br /> -, d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED ESL+OW: i <br /> CD <br /> 0 1-ai4d use_ A1 .n <br /> ..41`f' fr �je o 67�/tt 7d P'' `'- z <br /> n e ) -v- . 47 c.44_vim, by 4�z///zo z..Z.. r;), /s <br /> �.. (DuI'/dt& Wtle—V�2_ 4i'S iv ) k•etwo/e 7o/ <br /> e_ S/' I 9� S l4 c�. <br /> x Fee Rec: ��-'" <br /> � � <br /> Ck#: �:- `r <br /> a <br /> rn <br /> 11/ <br /> �J'Date of staff site visit: q/247Zp Z Z Initials of sit vis' staff: /t r—tillrTir, <br /> F <br /> PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE:Veø2bj© <br /> Page 1 of 3 <br /> Burnett County, WI Sign Application-Rev 12/2021 ' <br />