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SIGN PERMIT APPLICATION — Burnett County, 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: Town of Scott <br />Property Owner's Mailing Address: 28390 County Road H, Spooner, WI 54801 <br />City State Zip <br />Contact's Telephone Number: 715.635.2308 <br />Contact's Email: townofscottwi@gmail.com <br />Legal Description of Property: Lot 3 CSM V 14 P 74 (NW NE) (Town Hall) <br />Section #: 21 Town #: 40 N Range #: 14 W Town of: SCOtt <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): 07-028-2-40-14-21-1 02-000-016000 <br />Tax ID # (1-5 digits): 18351 <br />Property Site Address: 28390 County Road H, Spooner, WI 54801 <br />TYPE OF PERMIT(S): Check appropriate box/boxes <br />❑ Off -Premise ® On -Premise ❑ Directional (Off -Premise) <br />Sign Contractor: Northland Sign <br />Anticipated Construction Start Date: 10/15/18 <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELMorl <br />r r <br />-- c� en qe_ c S <br />lM po ► r <br />—�t tO 11A pv� tA d C_ , el 33 - 1--t-11 c— <br />Date of staff site visit: Initials of site visit staff: <br />/ p <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: <br />Page 1 of 3 <br />Burnett County, WI Sign Application — Rev 3/2018 <br />z <br />00 <br />b <br />n <br />S <br />D <br />z <br />M <br />&,,,,+ II <br />Fee Rec: <br />I - N <br />