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APPLICATION FEE: $250.00 CONDITIONAL PERMIT#W -14-03 ZONING U-3 <br /> (For Office Use only) <br /> ####kk#########kkkkffiiFFFMiiififikkfffiFFFFifiiiiikkiiiiiFFffF#####k###k########### <br /> BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 COUNTY ROAD Y,#102 JIM FLANIGAN <br /> SIREN,WISCONSIN 54872 (715)349-2138 <br /> ....................................................................................r <br /> COUNTY OF BURNETT CONDITIONAL USE APPLICATION ZONING COMMITTEE <br /> (D (WE) SBA Toxeis V,LLC and Verizon Wireless as Tenants to L&E Erickson Family Limited partnership <br /> do:Ta M Really Senecas,Inc.,P.O.Bait 578790,Chicago,IL 60657 Peter Schau:(773)919-5112 <br /> (MAH,ING ADDRESS) (TELEPHONE) <br /> HEREBY MAKE APPLICATION TO THE ZONING COMMITTEE FOR A CONDITIONAL PERMIT FOR THE <br /> FOLLOWING: <br /> New SBA Communications owned wireless communications tower facilely consisting of a new 195'monopde taxer(199'overall height wAightning rod),a <br /> V x 90 fenced canpound(wh 100'x 100'lease parcel)and a new 12'wide aoxss drive(wfi 20'wide accessluhliN easement). Installation and operation d <br /> VarzDn Wireless equipment upon the faolay consisting of up to 12 panel type antennas and assoaded equipment at the 190'CL,13 anauhybdd cable,and <br /> placement of a 1 I x 25'5 ill'equipment shelter and interior generator upon a concrete padRoundation wfi the SBA lanced compo ed per plan. <br /> LEGAL DESCRIPTION OF PROPERTY:CUVI Lel 1 NW 1N NW 114Section 20 Township 41 Nath Range 15W.. <br /> TBD-Tower FadNy PINM07-032-241-15-20505001-011000 <br /> FIRE#:30761 istina SEH ROAD NAME: Tabor lake give <br /> PRESENT IMPROVEMENTS UPON LAND: Single Family Home(Nath of Tabs Lake Or.),Vacam Wooded Lad(South Of Tabor Lake Or.) <br /> PROPOSED USE: Uwanned WIMIMCOMmUnIORtars Tawa Fadlely lTelecanmunications Fadlity) <br /> LIST NAMES AND ADDRESS OF ADJOINING PROPERTY OWNERS: <br /> .30863 Taborlaw 0m.PINM07-032-2-41-1517305-005017000,Alex Yong-3860Canty Rd 140,Chaska,MN 55318. <br /> 2.PltW7-032-241-1520-1 01000 0110MBurnett County FC-7410 County Rd K,RM 105,Siren.WI 54872. <br /> 3.Plt M07-032-241-1517-3 04-000011000,Burnett County FC-7410 Canty Rd K,RM 105,Siren,WI 54872. <br /> 4.30717 Tabor Lake DmePNW7-032-241-15-193 05-003-0120110 Bette Rae Preus Rev Trust-ABn:Kann M Preus,Trustee,1064 Hauge Ave.SL Paul,MN 55104. <br /> 5.PINM07-M-241-1519505003017000,Beck Rae Preus Rev Trust-Ann:Kann M Preus,Trustee,1064 Hague Ave,SL Pad,MN 55104. <br /> urr <br /> NOTE: A PLOT PLAN DRAWING SHOWING THE COMPLETE <br /> LOT LAYOUT WITH SETBACKS AND DIMENSIONS MUST <br /> ACCOMPANY THIS APPLICATION. <br /> APPLICANT SIGNATURE J�� .a heWof SBA Texas V,LLC 8 Venom W rekss DATE I ZZ/1% <br />