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• <br /> OUTDOOR SIGN INSTALLATION APPLICATION AND PERMIT Mail Application to Regional Office <br /> Wisconsin Department of Transportation <br /> DT1680 6/2006 5.84.30 Wis.Stats. This Permit is Revocable. <br /> For Locations Adjacent to Interstate and Federal Aid Primary Highways and the National Highway System <br /> Applicant-Sign Owner / Area Code-Telephone Number <br /> 11 Aitur ®rAdeee,e Aolizaisi, 6.0 - .79/Z- .2.4�- <br /> Address, City,State,ZIP Code J <br /> /0,2 f 8 .� in ra'V, u/ / S31/3 <br /> �,/ jr / E-Mail Address <br /> X �(�'l 1'�4rv� S p f kW .;4440-60.,../44,..Co.•n <br /> (Perm' Applicant Signature) (Date) <br /> An agreement/lease with the landowner that allows installation of the described sign and continued access to the sign site must be obtained prior to <br /> approval of this application for all categories except on-premise. Nothing herein requires a property owner to have or to retain a sign on their land. <br /> Landowner Name —Print Area Code—Telephone Number <br /> AM /Ktitc. SAC fo0*- x'36- �/ .)q <br /> Address,City,State ZIP Code <br /> Pia&lot J4/4 '4WI/ifddI/AV id, 5,3SP2- <br /> By my signature, I acknotqledge that I am aware of the Permit Conditions and Restrictions listed herein and I affirm there are no easements or <br /> restrictions that would prohibit this sign from being erected. <br /> X j� A�lCM�CL i/oyof <br /> (Landow er Signature) (Dal <br /> Installer Name License Number <br /> /tc1 S Oz/ ,66zhe dobto,-45/4lg /d q <br /> Address,City,State ZIP Code ✓✓ <br /> /t 2 E. g 4a,!,4cd iI,as,; <br />