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Mobile Cellular Communication Tower Land-Use Permit Application <br /> Burnett County Zoning Department 'v <br /> 7410 County Road K,#102 ` <br /> Siren,Wl 54872 / ,� <br /> 715-349-2138, Fax 714-349-2166,zoning@burnettcounty.org ` 1 <br /> -r <br /> Burnett County regulates the placement of, and/or modification to cellular communication towers in accordance with <br /> Chapter 30, Article VI, Sec. 30-567 Burnett County Code, Chapter 66.0404 Wisconsin Stats. and Act 20, which was <br /> enacted by the Wisconsin Legislature on July 1, 2013. This permit application, once received by the Zoning Department, <br /> shall serve as the official notification to begin application completeness and permit issuance time constraints referenced in <br /> the above mentioned regulations. Once the application is reviewed, the applicant will be notified if more information is <br /> needed, or an issued land-use permit will be mailed to the applicant. <br /> Proposed project: (check one) <br /> ❑ New Tower <br /> ❑ Class 1 Collocation <br /> ® Class 2 Collocation <br /> "Class 1 Collocation means the placement of a new mobile service facility on an existing support structure, such that the owner of the facility does <br /> not need to construct a free standing support structure for the facility,but does need to engage in substantial modification. <br /> 'Class 2 collocation means the placement of a new mobile service facility on an existing support structure such that the owner of the facility does <br /> not need to construct a free standing support structure for the facility or engage in substantial modification. <br /> Substantial modification means the modification of a mobile service support structure, including the mounting of an antenna on the structure, that <br /> does any of the following: <br /> 1. For structures with an overall height of 200'or less,increases the overall height of the structure by more than 20' <br /> 2. For structures with an overall height of more than 200', increases the overall height of the structure by 10 percent or more <br /> 3. Measured at the level of the appurtenance added to the structure as a result of the modification,increases the width of the support structure <br /> by 20'or more, unless a larger area is needed for collocation <br /> 4. Increases the square footage of an existing equipment compound to a total area of more than 2500 square feet <br /> Please furnish the following information: (you may use additional sheets for items 3-6) <br /> 1. The name and business address of, and the contact individual for, the applicant <br /> SMJ International o/b/o T-Mobile, 49357 Pontiac Trail, Suite 206, Wixom, MI 48393 <br /> 2. The location of the proposed or affected support structure and/or the location of the proposed mobile service <br /> facility (if different from the tower location). <br /> S 390'of the SW 1/4 of the SE 1/4 of Section 13, Township 38N, Range 17W <br /> Legal description <br /> Tax I D# 1 2072 <br /> Map# <br /> Fire#(towers or facilities placed on new parcels are required to have a fire number) 1 8364 Waldora Road <br />