HomeMy WebLinkAbout010-941-28-4201-SGN-1988-003y Inttrntat?t a�'reaera�'i�iu - ...:.s:� - m ilghway Side
Primary Highway No. 1 '} 4( I dw11 - v _
w G OF: ❑ North ❑ South ❑ East &fWest
Proof supplied to Indicate that the land zoning Is: _
Sign to be located within the �_ ,A of the ,�_. '/4 of Section.
C` Township North, Range 7 W -- ❑ East ❑ West,
Since date of
Distance between sign site and nearest highway Intersection t
Indicate part of Intersectlon from which measurement taken.
of
(Feet) _ [Eas! West North South
Distance from the highway right of way line, at least: Sign to face: (Compass direction)
17
Name and address of person or company
either
(feet)
III Install the sign If approved:
L
SIGN CATEUbRY ✓
❑ On -Advertised Property and on building
❑ On -Advertised Property for guidance internal traffic
❑ Directional as defined by subsec. Trans. 201.05 Adm. Code:
(SignaRU'R
uired)
X
❑ Sign oed pool bus stop shelter
(affidci s required)
❑ Service Club or Chamber of Commerce Sign, or Religious Notice
(Signature of advertiser required)
tho regulated highway in
along toe regulated nlgnW ay:
Sign Illumination
S W Steady light ❑ No lights
Installer license number. It none, so stat
U3 On -Property Free Standing —
El Off -Advertised Property (advance inform)
❑ More than 660 feet from Highway right of way
❑ Official sign (City, Village, Town, County, State, official to be
applicant, and authorizing signature required).
X
X
SIGN TYPE:
Cl Single Face Back to Back ❑ Side -BY -Side ❑ "V" Type. ❑ over-under
Name and address of applicant (type or letter) Mail Completed Permit Application To:
r
Name: G .5 Telephone:
Street Address: lj Q 2-
City, State, ZIP: w
The undersigned applica t hereby requests permission to install and/or maintain signing as described herein.
A CHECK in the amount of $ ) a^ is enclosed herewith as payment of the permit issuance fee. (Make payable to Wisconsin
Department of Transportation.)
X A
DSte gnat re of Permit Applicant
.................................. .. PERMIT
Subject to compliance by the applicant with all requirements of Section 84.30, Wis. Statutes, with Chapt. Trans. 201, Wis. Administrative
Code, with other statutes and codes applying, and with all standard and special provisions on the reverse face hereof or attached hereto,
permit approval is hereby granted to authorize installation and maintenance of the specific advertising or informative display described
herein at the precise location herein defined. This permit will expire one year after the Permit ISSLiance Date if the sign permitted here is
not installed by that time, unless the Department has granted a time extension in response to written justifications therefor.