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Legal Description: yb,Dco <br />Lot #: CSM Vol. Pg. OR <br />Lot #: Block #: Subdivision Name: OR <br />Gov't Lot #: OR 1/4 1/4 <br />Section #: Town #: _N Range #:,(�,__W Town of�- (—G <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />Parcel # (24 digits): 0-4 —S34A — Z --�;J —1 00r --Z$ — A C) — ow 01 \CCL� <br />Tax ID # (1-5 digits): F -4b24 <br />n <br />Property Site Address: TRID, 2 t oc L c3 i 5q$ s <br />TYPE OF PERMIT(S): Check appropriate box <br />r\p'New Tower ❑ Class 1 Collocation ❑ Class 2 Collocation <br />Anticipated Start Date: 1 1 — Zu �� �p ,7Q ,��� �y:1 a,1 I 4wrb 0A 1 <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 101. Scale shall not exceed 1"=50'. Note the scale used on the drawing. Plot plan drawing shall be on letter <br />or legal 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 (OHWM) and distances to it from all existing and proposed structures; must show all within 200 ft of <br />structures <br />Floodplain and wetland areas/boundaries 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 />i 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 />Existing and proposed parking (Commercial/Industrial Only); must show dimensions, width, and proposed number of stalls <br />*List continues on next page <br />Page 2 of 5 <br />Burnett County, WI Tower Application — Rev 1/2017 <br />