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Legal Description: <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4—1/4 <br /> Section#:—Town#:_2aL_N Range#: I '::�_W Town of:: <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): O� —��`[I— —3� —1 —Z�—1 d4 -'6OQ--©1`� <br /> Tax ID#(1-5 digits): F-4b 44 <br /> Property Site Address: �y• n—1 �Y I��sc k L3 \ 5q g 5 3 <br /> TYPE OF PERMIT(S): Check appropriate box <br /> 'New Tower ❑ Class 1 Collocation ❑ Class 2 Collocation <br /> Anticipated Start Date: 1 ^ 70-7 DP.0 V�� /J1A Ck (I PnI S ) <br /> A plot plan drawing is required to he submitted along with this application. Plot plan shall be drawn with a scale preferably at <br /> 1"=20'or multiples of 10'. Scale shall not exceed 1"=501. Note the scale used on the drawing. Plot plan drawing shall be on letter <br /> or legal size paper with North being at the top of the page. (Make sure all items below are shown—check each box): <br /> Property lines,road right-of-ways,and road centerlines including distances to property lines,road right-of-ways,and road <br /> centerlines for all existing and proposed structures on the parcel <br /> Ordinary High Water Mark(OHWM)and distances to it from all existing and proposed structures;must show all within 200 ft of <br /> structures <br /> Floodplain and wetland areas/boundaries and distances to them from all existing and proposed structures;must show all within 200 <br /> ft of structures <br /> Proposed structures and their proposed locations including all decks/porches/walkways/etc;must show dimensions for ALL items <br /> Proposed sanitary system,drainfield, and proposed well location including distances to property lines,road right-of--ways,and road <br /> centerlines <br /> Existing structures on the parcel including all decks/porches/walkways/etc and including any existing sanitary system, drainfield, <br /> / and wells;must show dimension for ALL items <br /> l Heights for all existing and proposed structures *Height is measured from lowest adjacent grade to the highest roof peak and <br /> (\ to the highest point of the tower <br /> Existing and proposed parking(Commercial/Industrial Only);must show dimensions,width,and proposed number of stalls <br /> *List continues on next page <br /> Page 2 of 5 <br /> Burnett County, WI Tower Application —Rev 1/2017 <br />