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Legal Description: 5 G IV C- <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR-3 E 1/4 NE 1/4 <br /> Section#:. 25 Town#:_3 -�_N Range#: 15 W Town of: Tra�e L 64 KZ <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 -7 - 0 3 + - 2 -3 7 - 4 -2 Y/- ) 0 q " 00 0 - 0 ) 1 0 0 0 <br /> Tax ID#(1-5 digits): 2 4 07 1+ <br /> Property Site Address: � C 0 u n fiy C Z �- G , W S S <br /> TYPE OF PERMIT(S): Check appropriate box <br /> ❑ New Tower ❑ Class 1 Collocation Class 2 Collocation <br /> Anticipated Start Date: <br /> colt s/l01 <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 /> ❑ 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 1/2019 <br />