2019/10/11 - LAND USE - LUP - Class II Collocation - LUP-19-454

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❑ Existing and proposed driveway(s);must show dimensions and width *Driveways must have a cleared width of 20 ft and a cleared height of 13 ft ❑ North arrow ❑ Vegetation proposed to be removed or disturbed ❑ Existing and proposed utilities and utility easements ❑ Location and extent of proposed filling/grading ❑ Location and type of erosion-control measures ❑ Fall radius and fall zone ❑ Distance to all nearby structures,within a distance equal to the height of the tower,as measured from the center of the tower ❑ Any other construction related to your project • Construction plans shall be submitted with this application for all items subject to Uniform Dwelling Code(UDC) inspection. Construction plans shall show interior layout,exterior profiles, and exterior heights. • Construction plans shall be submitted with this application for all non-dwelling(Commercial/Industrial)related construction. Construction plans shall show interior layout, exterior profiles,and exterior heights. • Proposed building/structure locations must be staked prior to submitting this application to the Land Services Department. County staff will do an onsite visit to verify site conditions. If all proposed structures(including fences, out buildings,retaining walls,etc)are not staked upon County staff visit,the permit will NOT be issued and it will be returned to the applicant. • If all existing structures on the parcel are not shown and dimensioned on the plot plan drawing,the permit will NOT be issued and it will be returned to the applicant. - If this application is to substantially modify an existing support structure, a construction plan is required which describes the proposed modifications to the support structure and the equipment and network components,including; antennas,transmitters,receivers,base stations,power supplies,cabling, and related equipment associated with the proposed modifications. - If this application is to construct a new support structure,a construction plan is required which describes the proposed support structure and the equipment and network components, including; antennas,transmitters,receivers,base stations,power supplies, cabling, and related equipment to be placed on or around the proposed structure. - If this application is to construct a new support structure,an explanation is required as to why the applicant chose the proposed location and why the applicant did not choose collocation,including a sworn statement from an individual who has responsibility over the placement of the support structure attesting that collocation within the applicant's search ring would not result in the same service functionality, coverage, and capacity; is technically infeasible;or is economically burdensome to the service provider. - A structural certification is required showing that the support structure, or existing structure is designed to collapse within a smaller area than the fall zone,if applicable. Page 3 of 5 Burnett County, WI Tower Application—Rev 1/2019