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10.2'l/2014 22:48 3492166 B C ZONING <br /> 1 <br /> .. S160 <br /> .... <br /> S So <br /> C07"Mer4ial D);t <br /> WAlt— S 23 <br /> BURNETT COUNTY SIGN PERMIT <br /> (2 <br /> A ddtes.5 <br /> Phone#: <br /> r r=t <br /> Mion <br /> -Type. Off Pr�mjse C) on Prernise Directional M <br /> To.wh <br /> 7 -V4�1/4 Property Zoning <br /> �Iighway Road Name Hishway/Road SideN, [I <br /> W . <br /> 'I)';t;t <br /> arice f'ronl Highway/Road Right-Of-Way <br /> lli?,*Mde `)vtv!cen sign location and nearest road intersection is <br /> ). -1 feet, <br /> '�CM�eell SiSm location and centerline ofroaAighwayT�S' <br /> —--------- <br /> ]:)"tqRce &on '3t existing offpremise sign(OffPrmise sign. <br /> applicants only) f <br /> Numj)er of ex. <br /> "'Sting free standing sip$(on-premise or <br /> 11y) g� <br /> d'ng"y WOmPanving schedule)has been examined by me and to the <br /> talo,ca7ract and complete, I acknowledge that I am res <br /> C*'Ifainod in thin it Ponsible for the detail and <br /> any accQv"Pall.'429 schedule)and I I <br /> .application(including further declare that I rrco,014, <br /> 11"r PTOviding will be relied upon by the C�ounty of Burnett Wic f! �� I <br /> I <br /> ftj­ther accept all liability which may be a result of t1le consin in d"crtnining <br /> oft relying on this information i aryl,- <br /> peP4,Ax to bane acdess to fire a6vow IciAls charged with administering tounty ordinances <br /> ;Iwli" zgroc a3 Permit County Ofr County of Burn <br /> Pr at t4 th <br /> �'y <br /> Pr <br /> or othcr,�j� <br /> any <br /> rca, <br /> bed s an�.od,, <br /> 9111ble firno fbr the purpose of inspect <br /> :,.natnrc Anplic ant, <br /> � �- -, ' <br /> YJ <br /> ropftrty Owner: <br /> k ik,-tch ;]NstratirR tilt 5i7 <br /> .e(bv dimensions), shape <br /> and Illessa@&of sign- <br /> I' <br /> ,,g <br /> !';,:)vidc site Tan.1 9 del"jV9 J00flilion and positionill <br /> -ata,rood riovT F(m`JT'#tt-Qf-WaYs and Cxifting sighs. <br /> on property with referenced distan(,es to prQPer'y <br /> DATE: �,�.� <br /> 3aJ 3WOH JO Si6OJW03 <br />