Laserfiche WebLink
UNIFORM ORDINANCE CITATION <br /> BURNETT COUNTY SECTION 66.119(1), WIS. STATUTES Forfeiture <br /> STATE OF WISCONSIN DEPOSIT PERMITTED B.C. j 2 2 4 $__t__ Penalty Assess. <br /> THE UNDERSIGNED,BEING DULY SWORN AND UNDER Court Costs <br /> OATH,COMPLAINS FOR AND ON BEHALF OF THE <br /> COUNTY OF BURNETT UPON INFORMATION AND CIRCUIT COURT OF BURNETT COUNTY <br /> BELIEF,THAT ON OR ABOUT, $ TOTAL <br /> DAY OF WEEK DATE VIOLATION TIME El AM COUNTY- ,p --- TWP-VILLAGE-CITY <br /> Wei' _ 3—GJ ❑ PM `aK-./p�'1 17 _a <br /> NAME AST ,FIRST /�'MI DATE OF BIRTH AGE <br /> 1.4 JIB 5 .E5/J�er- /` ) MO. DAY YR. <br /> STREET OR ROUTE' CITY,STATE,ZIP COPPE� �. SEX 0 M <br /> S�r9 t YJU� V� I 5 J S-3 0 F <br /> DID UNLAWFULLY Us.- i n :r 7 <br /> ON THE ABOVE STATED TIME,DATE AND LOCATION,THE DEFENDANT(DESCRIBE VIOLATION—STATE FACTS) <br /> in violation of section(s) of the ❑ Ordinance <br /> and prays that he/she may be held to answer therefor. ❑ Burnett Co.ordinance adopting sec. <br /> Signature of Officer <br /> SUBSCRIBED AND SWORN TO Before me this date 19 Title <br /> Name Title Department or Agency <br /> YOU ARE HEREBY NOTIFIED TO APPEAR IN THE <br /> ABOVE NAMED COURT <br /> THE MAXIMUM FORFEITURE FOR THIS VIOLATION IS$ <br /> r _7) fl A.M. <br /> ON'L— J \) gr._AT 0 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 />