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SIGN PERMIT APPLICATION — Burnett Countv, WI <br />Permit Fees: <br />Off -Premise $100 <br />On -Premise $50 <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. <br />Applicant Complete All Sections Below This Line <br />Property Owner's Name: VAU nAs v, - C 1 e Y V,- e4 <br />Property Owner's Mailing Address: I;S `t 4 (Y\�ZAX t l 12 <br />City State Zip <br />c� <br />Contact's Telephone Number: <br />( <br />Contact's Email: S o e. 1 V Pa S U Ce ✓ (2 C,0 WN <br />Legal Description of Property: L�l t 10O 1-1 Z f (1 J9 3 <br />Section #: `2-0 Town #: N Range #:__I_la_W Town of: Mee )t..,l(l�`-� <br />*Attach additional page if needed for lengthy description OR attachaof the deed OR attach tax system property page. <br />_copy <br />++ <br />Parcel # (24 digits): - " Z "� 1 10 0 - Q 0 0 - 0 (q d 0 0 <br />( <br />Tac ID # (1-5 digits): Z <br />Property Site Address: 10 C[� e—JV A- ,cy C,, C( <br />TYPE OF PERMIT(S): Check appropriate box/boxes <br />❑ Off -Premise L79--0n-Premise ❑ Directional (Off -Premise) <br />Sign Contractor: �� � '( 1},L ,x <br />Anticipated Construction Start Date: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERIVHT IS SUBJECT TO L CONDITIONS LISTED BELOW: <br />�It IV) bA �n/crt- ► <br />o rt / Sze <br />— G✓� S U /til <br />Q' <br />Date of staff site visit: -711E-hs-of sit visit staff: / <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: <br />Page 1 of 3 <br />Burnett County, WI Sign Application — Rev 3/2018 <br />to <br />z <br />00 <br />G <br />_yl- <br />o <br />o <br />Q <br />sVo <br />C v � <br />0 <br />} 1 <br />ro � <br />N <br />o � <br />Q n , <br />d � <br />r Q <br />z <br />z <br />Fee Rec: <br />v <br />r� <br />