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MOBILE -CELLULAR -COMMUNICATION TOW COMPUTE <br />LAND USE PERMIT APPLICATION <br />Permit Fees: <br />New Tower $3000 <br />Class 1 Collocation $3000 <br />Class 2 Collocation $500 <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 permit <br />will be needed for structures on the jzround. <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 Zoning Office, 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 <br />is reviewed, the applicant will be notified if more information is needed, or an issued permit will be mailed to the applicant. <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. <br />Class 2 Collocation means the placement of a new mobile service facility on an existing support structure, such that the <br />owner of the facility does not need to construct a free standing support structure for the facility or engage in substantial <br />modification. <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: <br />- For structures with an overall height of 200 ft or less, increases the overall height of the structure by more than <br />c <br />20 ft <br />= <br />For structures with an overall height of more than 200 ft, increases the overall height of the structure by 10 <br />0 <br />percent or more <br />H <br />Measured at the level of the appurtenance added to the structure as a result of the modification, increases the <br />�. <br />width of the support structure by 20 ft or more, unless a larger area is needed for collocation <br />L <br />Increases the square- footage of an existing equipment compound to a total area of more than 2,500 square feet <br />�1 <br />Applicant Complete All Sections Below This Line <br />Parcel Owner Name: -(N C&n <br />Parcel Owner Mailing Address: 2b 11bz <br />City State Zip <br />Applicant's Name <br />Applicant's Business <br />n <br />d <br />IV <br />OL <br />4 <br />rw <br />is <br />0 <br />3 <br />z <br />Fee Rec�� bW <br />Applicant's Mailing Address: 1A 4 5 _ConA: _A �1'j�.Df6YUP `7y'n_� o <br />—�— �� City State Zip c <br />Applicant's Telephone Number:71 C5 - (o C7 L7 n 7 <br />Applicant's Email:��-�y�x� ��.1,{ tCi11UL�Q S` . (Oh'\ z z Z4 <br />If staff has a question about this application how do you prefer to,ntacted? Check one below. O <br />[:]Letter❑Phone mail 4 o <br />< ti <br />Page 1 of 5 0 <br />Burnett County, WI Tower Application — Rev 1/2017 Q <br />