HomeMy WebLinkAboutEligible Facilities Request - OT General - 7/16/2019 i L K
ELIGIBLE FACILITIES REQUEST CERTIFICATION
FOR NON-SUBSTANTIAL CHANGES TO A WIRELESS TOWER
NOT LOCATED WITHIN A PUBLIC RIGHT OF WAY
1) Address of the Wireless Tower: Milepost 27-6, Hwy 3, Belfair, WA 98528
2)The height (measured in feet above ground level) of the existing Tower as originally
approved, including any modifications approved prior to February 22, 2012: 180'-0"
3) What is the height (measured in feet above ground level) at which the modifications to the
Transmission Equipment will occur on the Tower? 160'-0"
4. What will be the height(measured in feet above ground level) of the existing Tower after the
modifications to the Transmission Equipment are installed?-180'-0"
5) Effect of modifications of Transmission Equipment on Tower height:
(A)Will the modifications in Transmission Equipment (addition, removal or replacement of
Transmission Equipment) result in increasing the height above ground level of the
existing Tower?
❑Yes ®No
(B) Will the modifications in Transmission Equipment result in increasing the height above
ground level of the existing Tower by more than: (i) 10% of the height of the existing
Tower, as originally approved, including any modifications approved prior to February
22, 2012; or(ii)twenty feet between the top two antenna arrays?
❑Yes ®No
6) Will the modifications in Transmission Equipment (measured at the height above ground level
where the Transmission Equipment will be attached to the tower) result in any Transmission
Equipment protruding horizontally from the edge of tower the greater of more than twenty (20)
feet or more than the existing width of the tower at that height?
❑Yes ®No
7) Will the proposed changes in Transmission Equipment involve excavation outside the
existing leased or owned Tower site or outside any access or utility easements currently
related to the site?
❑Yes ® No
8) Will the proposed modification in Transmission Equipment involve installation of more than
four new equipment cabinets or one new equipment building?
❑Yes ® No
9) Will the proposed modification in Transmission Equipment defeat the existing concealment
elements of the Tower?
Non-Substantial Change Certificate for Towers Not within A Public Right of Way
❑Yes ®No
(10) Prior Conditions of Approval
(A)Will the proposed modification in Transmission Equipment comply with conditions
of approval imposed on the Tower prior to February 22, 2012?
®Yes ❑No
(B)If the answer to 10(A) is"No," is the non-compliance due solely to any of the
conditions addressed in questions 5-9 above?
❑Yes ❑No
If the answer to either question 5A or 5B is "No", and the answers to questions 6-9 are
"No", and the answer to either l0A or B is "Yes" then the proposed modifications do not
substantially change the physical dimensions of the existing Tower. Please provide a brief
explanation, if necessary,to clarify any answer.
Explanatory Comments (If Needed):
Question No.
Comment:
This certification is at his16thday of July, 2019.
c
gnature
Amanda Nations, Real Estate Specialist
Name & Title
Non-Substantial Change Certificate for Towers Not within A Public Right of Way
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