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Legal Description:-&H-4 w`J�% qS cc I y T me g d e t q <br /> Lot#: CSM Vol. Pg. _ OR <br /> Lot#: Block 4: Subdivision Name: OR <br /> Gov't Lot 4: OR_ 1/4 1/4 <br /> Section 0: 1% Town#:_ N Range#:_(_qW To,.m of: SCO �- <br /> 'Attach additional page ifneeded fi r lengtlry descriptian OR attach a copy of the deed OR attach!ax system property page.' <br /> Parcel#(24 digits): ` O Z R- Z ' 1-10, I LI ' 1(j_ 2- p 3- Q O O , O 11 b 0 i J <br /> Tax ID#(1-5 digits):_ <br /> Property Site Address#: Z B 4 g 2- <br /> Road <br /> Road Name:Q0009)► LA1!L City: S PC7t��sa J <br /> TYPE OF PERMIT(S):Check appropriate box <br /> ❑New Tower ❑ Class 1 Collocation )Class 2 Collocation <br /> Anticipated Start Date: a ' 16 ' (,E, <br /> A plot plan drawing is required to be 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"=50'. Note the scale used on the drawing. Plot plan drawing shall be on letter, <br /> legal or ledger 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(OH WM)and distances to it from all existing and proposed structures;must show all within 200 ft of <br /> structures <br /> ❑ Floodplain and wcfland areas/boundarics 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 /> ❑ 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 /> ❑ Fxisting and proposed parking(Commercial/Industrial Only),must show dimensions,width,and proposed number of stalls <br /> 'List continues on nextpage <br /> Page 2 of 5 <br /> Burnett County,WI Tower Application-Rev 3/2015 <br />