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MOBILE -CELLULAR -COMMUNICATION TOWER <br />LAND USE PERMIT APPLICATION <br />Burnett County, WI <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 <br />will be neededfor structures on the <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 1 <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 />20 ft <br />- For structures with an overall height of more than 200 ft, increases the overallheight of the structureby 10 <br />percent or more <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 <br />- Increases the square- footage of an existing equipment compound to a total area of more than 2,500 square feet <br />Applicant Complete All Sections Below This Line <br />Parcel Owner Name: Ameeucid lawa(a 4eA /A ff 6ejSe< <br />Parcel Owner Mailing <br />Applicant's Name: KG M 5 <br />p { i. fNkl?— 13:,vjm Le 1 C2 <br />City State Zip <br />Applicant's Business Name:��ael,f, C QA) ', (f 1 c 174f . G b k, 1~lzWei ra tr° r 4NPk' I A*aT <br />SctiA <br />Applicant's Mailing Address: 1 �N �1`� �k f l i t�� �a� a� F'cLa L <br />City State Zip <br />Applicant's Telephone Number: <br />Applicant's Email: KSChc7t'_bp( (--& <br />If staff has a question about this application how do you prefer to be contacted? Check one below. <br />FILetter E]Phone EREmail <br />Page 1 of 5 <br />Burnett County, WI Tower Application — Rev 3/2018 <br />r � <br />a <br />W � <br />V <br />b <br />o <br />V � y <br />o <br />C �J <br />2 ,c <br />ro <br />0 <br />a <br />w <br />O <br />v <br />H Q) <br />C6 <br />� z <br />� Fee Rec: <br />V -i. <br />-n <br />M <br />tvv <br />CMI <br />ca <br />r•� <br />W <br />