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Cn <br /> MOBILE-CELLULAR-COMMUNICATION TOWER 9 r <br /> LAND USE PERMIT APPLICATION y N <br /> Burnett County, WI <br /> a <br /> d <br /> Permit Fees: <br /> New Tower $3000 <br /> Class 1 Collocation $3000 ,11 <br /> Class 2 Collocation $500 1 XXXXX (� <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> *New Tower and Class I Collocation—this fee includes permits for related structures on the ground. <br /> *Class 2 Collocation—this fee does NOT include permits for structures on the ground. A separate land use <br /> permit will be needed or structures on the ground. �„ •�\ <br /> Burnett County regulates the placement of and/or modification to towers in accordance with Chapter 30,Burnett County <br /> Code of Ordinances,Chapter 66.0404 Wisconsin Stats.,and 2013 Wisconsin Act 20(which was enacted by Wisconsin on <br /> 7/1/2013). This permit application,once received by the Land Services Department,shall serve as the official notification to begin <br /> application review,and permit issuance time constraints referenced in the above mentioned regulations. Once the application z <br /> is reviewed,the applicant will be notified if more information is needed,or an issued permit will be mailed to the applicant. o <br /> Class 1 Collocation means the placement of a new mobile service facility on an existing support structure,such as the <br /> owner of the facility does not need to construct a free standing support structure for the facility,but does need to engage <br /> in substantial modification. y <br /> Class 2 Collocation means the placement of a new mobile service facility on an existing support structure,such that the c e <br /> owner of the facility does not need to construct a free standing support structure for the facility or engage in substantial a <br /> modification. <br /> C7 <br /> Substantial modification means the modification of a service support structure including the mounting of an antenna <br /> on the structure that does any of the following: d <br /> - For structures with an overall height of 200 ft or less,increases the overall height of the structure by more than N 00 <br /> 20 ft °n <br /> - For structures with an overall height of more than 200 ft,increases the overall height of the structure by 10 <br /> percent or more C7 <br /> - Measured at the level of the appurtenance added to the structure as a result of the modification,increases the , <br /> width of the support structure by 20 ft or more,unless a larger area is needed for collocation v, <br /> - Increases the square-footage of an existing equipment compound to a total area of more than 2,500 square feet c <br /> Applicant Complete All Sections Below This Line -� <br /> Parcel Owner Name: SBA Tower X, LLC <br /> r <br /> Parcel Owner Mailing Address: 8051 Congress ave Boca Raton FL 33487 z <br /> City State Zip <br /> Applicant's Name:T-Mobile_Shane Stubblefield. SBA Agnet 1 <br /> Applicant's Business Name: T_Mobile = Fee Rec: 5-66 <br /> Ck#: t'�0 <br /> Applicant's Mailing Address: 4800 Colfax ave S Minneapolis MN 55419 <br /> City State Zip a <br /> Applicant's Telephone Number: 6S1 gag ann2 <br /> Applicant's Email: sstubblefield _sbasite.com m ca. <br /> 3V <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address a, <.3R <br /> is legible and your email provider will accept emails from the following address:@BumettCountyWI.gov z (D n <br /> 00 <br /> Page 1 of 5 <br /> Burnett County,WI Tower Application—Rev 11/2024 m Ul) <br /> o <br /> y <br /> .9 <br />