DCPZP-2001-01099 - Laserfiche WebLink

Home Browse Search

OUTDOOR SiGN INSTALLATION APPLICATION AND PERMIT Wisconsin Department of Transportsdmi 1ntsrstate and Federal Aid Primary Highway Systems 9.144 1295 Applicant Instructions: Submit the following to the District Office identified in the block entitled,'Wail Completed Permit Application To:' A 3 copies of this application with all entries completed down to broken line; copies of a sketch llusbating the size (by dimensions), shape, color scheme and'message of the proposed display; C. 3 with respect to the highway, direction(s) of the sign's facing(s), and whether the display volt C. 3 copies of a site plan drawing, detailing sign positioning be on a building or free standing. The location for On property signing shall be referenced (distance shown) to the nearest part of the building to which the activity is conducted or managed Include on the drawing the locations of property lines and development features, such as customer parldng mss: a to how the property is zoned: include.date current zoning was established.a i copy of documentation from the zoning y prove to the effect current zoning the land is stablish; if no zoning has been assigned to the property, include a statement from the jurisdictional zoning authority • E A check or money. order(no cash) made payable to Wisconsin Dept. of Transportation to cover the required perm fee. (See Item#6 on back.) S.Nitllrear� 2.Canty 3.®Town j� City 0Wage• 4.nighwaySide ►2 orth 0 Eat _ of lip1ltw� II Doyle, oc Sfr1ayFie/ri 0 South Awed 8 l.asrd=Pirr0 used Data at mn%i5 Q • a.Sign Location ,/ C` csm) / 9 9 -1 54, bated within IM/V.d c quarter at the quarter at S.cOon —4.2a-- " �y.�s c i3 Eat p�peed sign meats as local zoning raquiremerds Township Nerds, Range p 0 wed �Y'ES ❑� 1.Oisse batman Plinamed sign see and nearest inteesecting highway.reed wiliest - 1 41° ■aS* .at the w.derer e al _ i't2 O Sf e y j• (Fein Most West Norer.•sauth) ,/ I 9.5gn to face( dire r) 10.Sigm a umination g•a ae:�e rrorrr tine iM9imrar�dway Gr. So i sc. >i /weSf 0Np 11.Narneandaddeesal pawn oroomgsrywhowrliiasliathe sign ransomed 4,1 el n i t s. 4Ufetoor AdveI. 1z erlicensenmmberft na»,sestets. I11tii C`�'a.iy 4.11; 'o.d. .5. 8ad9er Rd, ' . Jefer17fe- 5 (a (e. • Ma d/304, w! • 3-39/3 I D 9 is. n Type 13. Sign Category Face .. �.y. Type More than y 660 b of the folcmku: o Bade to �k- . 0 Over Under �Y apply ❑On Advertised Property Free Standing o Side by Side Q On Advertised Property and on building 16.Am/car/Mame l Telephone 0 on Advertised Property for gu dar+ce at internal traffic Ada Vr)5 O ct f-d ao r Ad oe(/- S•r./)q El Off Advertised Property(Must complete item 17 on back) Street Address ❑Service Club' /c a E. _ .c d q e r A. . o Religious Noire Cit.State,Tip ❑Sign on officio,desisted school bus stop sheler • - m er ell.J o/1 (.v/ 53 7/3 Affidavit from school officials required /Completed permit App{lion To Don Disbid otiie.c Joel Seaman, Sign Permit Coordinator o Directional as defined by Subset. Trans.201-05 Admin. Code Technical Services Section (Must complete iten lT on Wisconsin Dept. of Transportation U box is 'adver6s� 'below Wisconsin Wright Street ❑Official sign (City. age. Tom+. County, state. official to be appgcant) Madisoa, WI 53704 a bast is k#iedoed,official sign belovtr. - The undersigned apps requests permission to install andlor • maintain signing as.described. er / 3 - 1q-o1 re..- ./AppRc+nq (Date) (14.Advertiser OR Oeicial Signature) PERMIT Sub ect to compliance by the applicant with all requirements of 3.84.30 Wis..State.,with Ch.Trans.201 Wis.Admin.Code,with other statutes and codes applying, and will all standard and special provisions on the reverse face or attached,permit approval Is gran':d to authorize.installation.and maintenance of the specific informative or infoative display described at the precise location defined. This permit will expire one year after the Permit Issuance 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. Access from the travel lane or any interchange ramp of any Interstate highway or any other controlled access highway for the installation,maintenance or repair of the sign is expressly prohibited. This Permit is Revocable. Completed by Wisconsin Department of Transportation: • R.P.Number Sign Area(s4 R) CleckNumber Fee Received_. d Peanitkar suce Rate PermitNumber - 18 (, .0.5 7t' 5W 4/7y// $ S )(Y y.-05-0/ 1 .7 -17) i Record Number c ! ,. /'-e1- ...4,--- • 17t') CI ey (App for Director at Highway Operations)