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Use Variance 1-2019 Application Application for Use Variance Permit And Site Plan Approval New Wireless Telecommunication Facility 55 State Route 149 Town of Queensbury, NY 12804 November 13, 2019 Mr. Craig Brown Zoning Administrator Town of Queensbury 742 Bay Road Queensbury, NY 12804 Re: Application by Tillman Infrastructure for a Use Variance Permit and Site Plan Approval for the Installation and Operation of a 250-foot Wireless Telecommunications Facility and Related Equipment at 55 State Route 149, Lake George, NY 12845 Dear Mr. Brown, Enclosed for consideration, please find Tillman Infrastructure’s application for a Use Variance Permit and Site Plan Approval to construct a Wireless Telecommunications Facility located at the above referenced address. In support of the application, please find enclosed the following supporting documentation as required per Code and our Pre-Submission Conference: • Use Variance Application Form - Exhibit A • Criteria for Telecom Use Variance with Applicant Responses - Exhibit B • Site Plan Review Application Form – Exhibit C • Requirements for Site Plan Approval with Applicant Responses – Exhibit D • Deed – Exhibit E • Propagation Maps – Exhibit F • Existing Tower Inventory – Exhibit G • Zoning Drawings including Survey, Site Plan and Elevation – Exhibit H • Capacity for future shared use is addressed in the enclosed Zoning Drawings – Exhibit H • E-911 Address Verification – Exhibit I • Photo Simulations – Exhibit J • Neighboring Municipality Notification Letters – Exhibit K • Standards for Placement – Exhibit L • Site Relocation Letter to SBA – Exhibit M • FAA Determination of No Hazard – Exhibit N • Application Fee Checks of $100.00/$100.00/$500.00 – Exhibit O Tillman would like to emphasize that their proposal to construct an additional tower in your jurisdiction is intended for the consideration of any and all wireless providers (carriers, wireless internet providers and E911) interested in improving service to the greater Queensbury area. We have approached this project as thoughtfully as possible with an emphasis on blending the needs of the local citizenry with the need of our wireless clients. A clear requirement for additional antenna siting options spurred this request from the wireless providers. The search area request by Tillman’s client asked for a 250’ antenna height within 1500’ of their existing facility. No existing towers or structures that meet their requirements were found within that geographical area. The proposed tower will meet the requirements of Tillman’s client, increasing their antenna height by approximately 100’ over their current location. The proposed location is heavily wooded and selected to limit the amount of visual impact. (See Exhibit J – Photo Simulations) Tillman is constructing this tower to allow their clients flexibility, efficiency and economy in providing, upgrading and improving its service to all consumers. Our client’s business arrangement with their current infrastructure provider does not include provisions for our client’s future needs. Delays by the current infrastructure provider have adversely affected our client’s wireless functionality and impacts both the carrier’s customers and public safety users. Additionally, the current rent charged to co-locate upon the existing structure is multiple times the going market rate and is economically challenging to the wireless provider, who in turn must share these additional costs with the end user customers. Our proposal not only allows for better and more comprehensive mobile wireless service to your community, it also allows Tillman’s tenants the ability to control and reduce costs which are part of the basis of the costs charged their customers, the wireless users. It should be noted that proposed Anchor Tenant, AT&T, has attempted to renegotiate terms of their Lease prior to extending or terminating option years with current tower owner, SBA Corporation. (See Exhibit M- Site Relocation Letter) Furthermore, this proposed Tillman tower will increase AT&T’s coverage area and provide for deployment of 5G and other next generation technology across the U.S., including FirstNet, public safety’s dedicated, nationwide communications platform. The First Net program, which is a federally funded program for local, state & federal agencies First Responders, is designed to help all E911 agencies communicate and access data quickly to fulfill their duties. (See Exhibit F – Propagation Maps) Please be advised that as part of Tillman’s request for a Use Variance Permit, we will need relief from Zoning Section 179-5-130-C. (1) Placement of Telecommunication Facilities in a RR-3A Zoned Area. In summary, a new tower at the proposed location would address the following… • The proposed Increased Antenna Height would improve AT&T’s Coverage Area. • The proposed new tower would allow AT&T to enhance deployment of 5G and other next generation technology introduced across the U.S., including FirstNet, public safety’s dedicated, nationwide communications platform. • Carrier confirmed the existing tower does not currently have First Net. The new tower will have First Net, the National First Responders Network. • Natural Screening Limits Visual Impact. Upon review of the submittal package, please advise if the package is considered complete for a Use Variance Permit and Site Plan Approval. If the submittal package is deemed complete, we respectfully request to be placed on the next Planning Board agenda for Recommendation on December 17, 2019, the Zoning Board of Appeals Agenda on December 18, 2019 and the Planning Board Agenda for Approval on December 19, 2019. We look forward to working with you and staff to help bring state of the art wireless telecommunications to the residents and workforce in your area. Please do not hesitate to contact us if you have questions, concerns, or require additional information. Sincerely, Tony Phillips Tony Phillips Zoning & Permitting Manager Fullerton Engineering for Tillman Infrastructure and AT&T 847-331-3659 tphillips@fullertonengineering.com Use Variance [ZBA approved September 21 2016] General Information Tax Parcel ID Number: ____________________ Zoning District: ____________________ Detailed Description of Project [includes current & proposed use]: __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Location of project: ________________________________________________________________________________ ________________________________________________________________________________ Applicant Name: Address: Home Phone Cell: Work Phone Fax E-Mail: Agent’s Name: Address: Home Phone Cell: Work Phone Fax E-mail Owner’s Name Address Home Phone Cell Work Phone Fax E-mail Page 1 Use Variance [ZBA approved September 21 2016] Site Development Data Area / Type Existing sq. ft. Proposed Addition sq. ft. Total sq. ft. A. Building footprint B. Detached Garage C. Accessory Structure(s) D. Paved, gravel or other hard surfaced area E. Porches / Decks F. Other G. Total Non-Permeable [Add A-F] H. Parcel Area [43,560 sq. ft. / acre] I. Percentage of Impermeable Area of Site [I=G/H] Setback Requirements Area Required Existing Proposed Front [1] Front [2] Shoreline Side Yard [1] Side Yard [2] Rear Yard [1] Rear Yard [2] Travel Corridor Height [max] Permeability No. of parking spaces Page 2 Use Variance [ZBA approved September 21 2016] Additional Project Information 1. Will the proposal require a Septic Variance from the Town Board of Health? _______________ 2. If the parcel has previous approvals, list application number(s): _________________________ 3. Does this project require coverage under the New York State Pollutant Discharge Elimination System (SPDES) Permit Program? __ Yes / __ No 4. Estimated project duration: Start Date: __________ End Date: __________ 5. Estimated total cost of project: _______________ 6. Total area of land disturbance for project: _______________ The following information is needed by the Zoning Board of Appeals and reflects the criteria for granting a Use Variance. Please respond to each item; use additional sheets if needed: 1. The applicant cannot realize a reasonable return, provided that return is substantial as demonstrated by competent financial evidence. ______________________________________________________________________________________________ ______________________________________________________________________________________________ 2. The alleged hardship relating to the property in question is unique, and does not apply to a substantial portion of the district or neighborhood. ______________________________________________________________________________________________ ______________________________________________________________________________________________ 3. That the requested Use Variance, if granted will not alter the essential character of the neighborhood _____________________________________________________________________________________________ _____________________________________________________________________________________________ 4. That the alleged hardship has not been self-created. _____________________________________________________________________________________________ _____________________________________________________________________________________________ Please take note:  Responses to items 1-4, above, must be provided for review by the Zoning Board of Appeals.  New York State Town Law 267-b requires that the Zoning Board of Appeals deny the variance - if any one, or more of the factors listed above is NOT PROVEN. Page 3 Use Variance [ZBA approved September 21 2016] Section 179-14-030 Application materials and site plan drawing is to include sufficient information for the Board to review and provide a decision. The applicant is to provide a site plan drawing(s) – a survey showing existing conditions, a proposed conditions map (see page 00 for specific criteria) and include any other attachments that address A - D as applicable to the proposed project. A. General Shown on Sheet # 1 Title, Name, Address of applicant & person responsible for preparation of drawing 2 Deed 3 North arrow, Tax Map ID, date prepared and scale [minimum: 1 inch = 40 feet ] 4 Boundaries of the property plotted to scale, zoning boundary 5 Principal structures, accessory structures with exterior dimensions 6 Site improvements incl. outdoor storage areas, driveways, parking areas, etc.: existing & proposed 7 Setbacks for all structures and improvements: existing & proposed 8 Elevations and floor plans of all proposed and affected structures B. Water & Sewer Shown on Sheet # 1 Project sewage disposal facilities, design details, construction details, flow rates, and number of bedrooms proposed 2 Water supply [i.e. well] & septic on adjoining lots with separation distances to existing or proposed on-site water supply and septic 3 Separation distances for proposed sewage disposal system to well and water bodies 4 Existing public or private water supply [well, lake, etc.]. Method of securing public or private water, location, design and construction of water supply including daily water usage 5 Percolation test location and results C. Parking / Permeable Areas Shown on Sheet # 1 Number of spaces required for project including calculations and justification: existing & proposed 2 No. of existing parking spaces, number to be removed, number to maintain and type of surfacing material [e.g., gravel, paved] 3 Provision for pedestrian and handicap access and parking: existing & proposed 4 Design details of ingress, egress, loading areas and cutting: existing & proposed 5 Location and character of green areas [existing and proposed], modification to green area, buffer zone to remain undisturbed 6 Lighting, location and design of all existing and proposed outdoor lighting D. Additional Site Development and Miscellaneous Shown on Sheet # 1 On-site & adjacent watercourses, streams, rivers, lake and wetlands 2 Utility / energy distribution system [gas, electric, solar, telephone]: existing & proposed 3 Location, design and construction details of all existing and proposed site improvements including: drains, culverts, retaining walls, fences, fire & emergency zones and hydrants, etc. 4 Square footage of bldg. area proposed for office, manufacturing, retail sales or other commercial activities: existing & proposed 5 Signage: Location, size, type, design and setback: existing & proposed 6 Waiver Request: provide letter with application requesting any waivers: please reference specific items 7 Commercial / Industrial Development requires submission of Landscaping, Stormwater Management, Grading & Lighting Plans 8 Identification of Federal, State or County permits required for the project together with a record of application for all necessary permits Page 4 Use Variance [ZBA approved September 21 2016] Pre-Submission Conference Form / Section 179-9-040 1. Applicant Name: __________________________________________________ 2. Tax Map ID ________________ Location: _______________________ 3. Zoning Classification __________ 4. Reason for Review: __________________________________________________________ 5. Zoning Section #: ________________________ 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed ____ _____________ General Information complete ____ _____________ Site Development Data Complete ____ _____________ Setback Requirements Complete ____ _____________ Additional Project Information Complete ____ _____________ FAR addressed ____ _____________ Compliance with Zoning Ordinance ____ _____________ Checklist items addressed ____ _____________ Environmental Form completed ____ _____________ Signature Page completed ____ _____________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ Staff Representative: ________________________________ Applicant / Agent: ________________________________ Date: ___________ Page 5 Use Variance [ZBA approved September 21 2016] This page includes the 1.) Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.) Authorization for Site Visits; 4.) Other Permit Responsibilities; 5.) Official Meeting Disclosure and 6.) Agreement to provide documentation required. OWNER’S AGENT FORM: Complete the following if the OWNER of the property is not the same as the applicant: Owner: _________________________ Designates: ___________________________ as Agent regarding the following: Variance ___ Site Plan ___ Subdivision ___ For Tax Map No.:________________ Deed Reference: Book____ Page ____ Date ____ OWNER SIGNATURE: ___________________________________ DATE: _______________ APPLICANT’S AGENT FORM: Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Owner: __________________________ Designates: ____________________________________ as Agent regarding the following: Variance___ Site Plan ___ Subdivision ___ For Tax Map No.:________________ Deed Reference: Book____ Page ____ Date ____ OWNER SIGNATURE: ___________________________________ DATE: _______________ 2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design, storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged directly to the applicant. Fees for engineering review will not exceed $ 1,000 without notification to the applicant. 3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner, Applicant, and his/her/their agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the subject properties for the purpose of reviewing the application submitted. 4.) OTHER PERMIT RESPONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval by the Zoning Board or Planning Board. It is the applicant’s responsibility to obtain any additional permits. 5.) OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Department to have a designated stenographer tape record the proceedings of meetings resulting from application, and minutes transcribed from those tapes constitutes the official record of all proceedings. 6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents, will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy I have read and agree to the above. ______________________________ _____________________________ _______________ Signature [Applicant] Print Name [Applicant] Date signed ______________________________ _____________________________ _______________ Signature [Agent] Print Name [Agent] Date signed Page 6 Page 1 of 3 Short Environmental Assessment Form Part 1 - Project Information Instructions for Completing Part 1 – Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 – Project and Sponsor Information Name of Action or Project: Project Location (describe, and attach a location map): Brief Description of Proposed Action: Name of Applicant or Sponsor:Telephone: E-Mail: Address: City/PO: State: Zip Code: 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no, continue to question 2. NO YES 2. Does the proposed action require a permit, approval or funding from any other government Agency? If Yes, list agency(s) name and permit or approval: NO YES 3. a. Total acreage of the site of the proposed action? __________ acres b. Total acreage to be physically disturbed? __________ acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? __________ acres Check all land uses that occur on,DUHadjoining RU near the proposed actioQ  8UEDQRural (non-agriculture),ndustrial Commercial Residential (suburban) $TXDWLF2WKHU 6SHFLI\ ƑForest Agriculture ƑParkland Unmanned Communications Facility NYS Route 149, Town of Queensbury, Warren County, New York (portion of SBL 288.8-1-21). Proposed construction of a 260 foot tall (266 feet tall when including the 6 foot lightning rod) self supporting unmanned communications facility. The tower structure will be designed to be capable of supporting multiple antenna arrays. Ata height of 266' AGL, the tower will require FAA aicraft obstruction lighting. The tower and related base station equipment will be enclosed in a 75' x 75' fenced compound. Access to the site will be via a new curb cut from NYS Route 149. A 14 foot wide gravel access road will be constructed to provide access and necessary utilities will be run underground from the State ROW. Tillman Infrastructure 646-578-8428 cwarburton@tillmaninfrastructure.com 152 W. 57th Street New York New York 10019 ✔ FAA - tower registration. FCC - Antenna registration. NYSDOT - curb cut. Queensbury ZBA - Use Variance. Queensbury PB - SUP/SPR. ✔ 2.44 .25 .48 ✔ ✔✔ Page 2 of 3 5. Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape?NO YES 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify: ________________________________________________________________________________ NO YES a. Will the proposed action result in a substantial increase in traffic above present levels? EAre public transportation services available at or near the site of the proposed action? FAre any pedestrian accommodations or bicycle routes available on or near WKHsite of the proposed action? NO YES 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: _____________________________________________________________________________________________ _____________________________________________________________________________________________ NO YES 10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable ZDWHU: _________________________________________ _____________________________________________________________________________________________ NO YES 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: ______________________________________ _____________________________________________________________________________________________ NO YES D'RHVWKHSURMHFWVLWHFRQWDLQRULVLWVXEVWDQWLDOO\FRQWLJXRXVWRDEXLOGLQJDUFKDHRORJLFDOVLWHRUGLVWULFW ZKLFKLVOLVWHGRQWKH1DWLRQDORU6WDWH5HJLVWHURI+LVWRULF3ODFHVRUWKDWKDVEHHQGHWHUPLQHGE\WKH &RPPLVVLRQHURIWKH1<62IILFHRI3DUNV5HFUHDWLRQDQG+LVWRULF3UHVHUYDWLRQWREHHOLJLEOHIRUOLVWLQJRQWKH 6WDWH5HJLVWHURI+LVWRULF3ODFHV" DUFKDHRORJLFDOVLWHVRQWKH1<6WDWH+LVWRULF3UHVHUYDWLRQ2IILFH 6+32 DUFKDHRORJLFDOVLWHLQYHQWRU\" NO YES  D. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain wetlands or other waterbodies regulated by a federal, state or local agency? EWould the proposed action physically alter, or encroach into, any existing wetland or waterbody? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: _____________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ NO YES E,VWKHSURMHFWVLWHRUDQ\SRUWLRQRILWORFDWHGLQRUDGMDFHQWWRDQDUHDGHVLJQDWHGDVVHQVLWLYHIRU ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Page 3 of 3 Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: ƑShoreline ƑForest Agricultural/grasslands Early mid-successional Wetland ƑUrban Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES 16. Is the project site located in the \HDUIlood plan?NO YES 17. Will the proposed action create storm water discharge, either from point or non-point sources? If Yes, a. Will storm water discharges flow to adjacent properties? b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: _____________________________________________________________________________________________ _____________________________________________________________________________________________ NO YES 18. Does the proposed action include construction or other activities that ZRXOGresult in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain WKHpurpose and sizeRIWKHLPSRXQGPHQWBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB ____________________________________________________________________________________________ _ NO YES 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: _______________________________________________________________________________ _____________________________________________________________________________________________ NO YES 20.Has the site of the proposed action or an adjoining property been WKHsubject of remediation (ongoingRU completed)for hazardous waste? If Yes, describe: _______________________________________________________________________________ _____________________________________________________________________________________________ NO YES I &(57,)< THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Date: _____________________Applicant/sponsorname:BBBBBBBBBBBBBBBBBBBBB______________________BBBBBBBBB__________________________ Signature: _____________________________________________________7LWOHBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Stormwater from the access road will be carried in swales to their intersection with the State ROW where the water will enter the existing state highway drainage system. TONY PHILLIPS - FULLERTON ENGINEERING Nov 13, 2019 ZONING & PERMITTING MANAGER PRINT FORM EEAF Mapper Summary Report Wednesday, November 13, 2019 1:51 PM Disclaimer:The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental assessment form (EAF). Not all questions asked in the EAF are answered by the EAF Mapper. Additional information on any EAF question can be obtained by consulting the EAF Workbooks. Although the EAF Mapper provides the most up-to-date digital data available to DEC, you may also need to contact local or other data sources in order to obtain data not provided by the Mapper. Digital data is not a substitute for agency determinations. Part 1 / Question 7 [Critical Environmental Area] No Part 1 / Question 12a [National or State Register of Historic Places or State Eligible Sites] No Part 1 / Question 12b [Archeological Sites] Yes Part 1 / Question 13a [Wetlands or Other Regulated Waterbodies] Yes - Digital mapping information on local and federal wetlands and waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 / Question 15 [Threatened or Endangered Animal] No Part 1 / Question 16 [100 Year Flood Plain] Digital mapping data are not available or are incomplete. Refer to EAF Workbook. Part 1 / Question 20 [Remediation Site] No 1Short Environmental Assessment Form - EAF Mapper Summary Report Page 1 of 2 $JHQF\8VH2QO\>,IDSSOLFDEOH@ 3URMHFW 'DWH 6KRUW(QYLURQPHQWDO$VVHVVPHQW)RUP 3DUW,PSDFW$VVHVVPHQW Part 2 LVWREHFRPSOHWHGE\WKH/HDG$JHQF\ Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept “Have my responses been reasonable considering the scale and context of the proposed action?” No, or small impact may occur Moderate to large impact may occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area (CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a. public / private water supplies? b. public / private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of i mportant historic, archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, waterbodies, groundwater, air quality, flora and fauna)? 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? SEAF 2019 PRINT FORM Page 2 of 2 For every question in Part 2 that was answered “moderate to large impact may occur”, or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting, probability of occurring, duration, irreversibility, geographic scope and magnitude. Also consider the potential for short- term, long-term and cumulative impacts. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. ________________________________________________________________________________________________ Name of Lead Agency Date _________________________________________________ _______________________________________________ Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer _________________________________________________ _______________________________________________ Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) 4IPSU&OWJSPONFOUBM"TTFTTNFOU'PSN 1BSU%FUFSNJOBUJPOPG4JHOJGJDBODF "HFODZ6TF0OMZ<*GBQQMJDBCMF> 1SPKFDU %BUF PRINT FORM Criteria for Considering a Variance The four (4) criteria usually associated with a use variance are different in this case. AT&T is considered a public utility under New York decisional law ( Cellular Telephone Company v. Rosenberg, 82N.Y 2d 364(1993) and a provider of ''personal wireless services" under the Telecommunications Act of 1996. As a result of these decisions, the following are to be shown by the public utility in order to gain a use variance: 1.) That the proposed improvement is a public necessity in that it is required to render safe and adequate service. The proposed Tillman/AT&T Wireless Telecommunications Facility will be considered Critical Infrastructure and allow AT&T to increase their coverage area and provide for deployment of 5G and other next generation technology, including FirstNet, public safety’s dedicated, nationwide communications platform. The First Net program, which is a federally funded program for local, state & federal agencies First Responders, is designed to help all E911 agencies communicate and access data quickly to fulfill their duties. 2.) That there are com pelling reasons, economic and otherwise, for permitting the variance. The current rent charged to co-locate upon the existing structure is multiple times the going market rate and is economically challenging to the wireless provider, who in turn must share these additional costs with the end user customers. Our proposal not only allows for better and more comprehensive mobile wireless service to your community, it also allows Tillman’s tenants the ability to control and reduce costs which are part of the basis of the costs charged their customers, the wireless users. 3.) Where the intrusion or burden on the community is minimal, the showing required by the utility should be correspondingly reduced. The proposed location is heavily wooded and will provide natural screening to limit the visual impact. The facility will be unmanned. The establishment, maintenance and operation of the proposed Wireless Telecommunication Facility will not create public hazards from traffic, traffic congestion or the parking of vehicles and/or equipment or be otherwise detrimental to the health, safety or general welfare of persons residing or working in the neighborhood or to the general welfare of the Town. Traffic access and circulation, road intersections, road and driveway widths, and traffic controls will be adequate. Off-street parking will be provided for a technician to visit the site approximately once a month in a van or small pick-up. 1 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 TOWN OF QUEENSBURY Site Plan Review Application Review Process: 1. Required Pre-submission meeting with staff to determine general completeness to be held no later than 1 week prior to deadline day. Call (518) 761-8265 or (518) 761-8220 for an appointment. 2. Submittal of complete application: 1 original and 14 copies of the application package by monthly deadline. 3. Determination of application completeness. All necessary information must be provided and appropriate fee(s) paid for consideration for placement on an agenda for that month. 4. Incomplete applications will not be considered for placement on any agenda until all missing information has been submitted. 5. Submittal to Warren County Planning, if applicable. 6. Planning Board meeting, generally the third & fourth Tuesday of each month. You will be advised in writing as to which meeting to attend. 7. Following the meeting you will be provided with a copy of the resolution stating the Board’s decision on your application. If your application was approved, the next likely step is a Building Permit. Final drawings must be provided for the next phase of review. If your application was denied, your project cannot proceed as submitted. DOCUMENTATION REQUIREMENTS (hard copy & electronic): Please submit 1 original & 14 copies of the completed application package to include: • Completed Application pages 2-9, signed & dated • Pre-Submission Meeting Notes: signed by staff • Copy of Deed • Checklist & Plot Plan • Environmental Assessment Form for any non-residential project • Fee: $100 (0 – 10,000 sq. ft.); $250 (10,001 – 30,000 sq. ft.); $500 (30,001 -100,000 sq. ft.); $1,000 (100,000+ sq. ft.) Staff & Contact Information: Craig Brown, Zoning Administrator craigb@queensbury.net Laura Moore, Land Use Planner lmoore@queensbury.net Sunny Sweet, Office Specialist – Planning sunnys@queensbury.net (518) 761-8220 Visit our website at www.queensbury.net for further information and forms 2 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 General Information Tax Parcel ID Number: ____________________ Zoning District: ____________________ Lot size: _____________________ Detailed Description of Project [includes current & proposed use]: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Location of project: ________________________________________________________________________________ Applicant Name: Address: Home Phone Cell: Work Phone Fax E-Mail: Agent’s Name: Address: Home Phone Cell: Work Phone Fax E-mail Owner’s Name Address Home Phone Cell Work Phone Fax E-mail 3 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 Site Development Data Area / Type Existing sq. ft. Proposed Addition sq. ft. Total sq. ft. A. Building footprint B. Detached Garage C. Accessory Structure(s) D. Paved, gravel or other hard surfaced area E. Porches / Decks F. Other G. Total Non-Permeable [Add A-F] H. Parcel Area [43,560 sq. ft. / acre] I. Percentage of Impermeable Area of Site [I=G/H] Setback Requirements Area Required Existing Proposed Front [1] Front [2] Shoreline Side Yard [1] Side Yard [2] Rear Yard [1] Rear Yard [2] Travel Corridor Height [max] Permeability No. of parking spaces 4 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 Additional Project Information 1. Will the proposal require a Septic Variance from the Town Board of Health? _______________ 2. If the parcel has previous approvals, list application number(s): _________________________ 3. Does this project require coverage under the New York State Pollutant Discharge Elimination System (SPDES) Permit Program ? _______________ 4. Estimated project duration: Start Date __________ End Date __________ 5. Estimated total cost of project: _______________ 6. Total area of land disturbance for project: _______________ Floor Area Ratio Worksheet FLOOR AREA RATIO (FAR) -- The relationship of building size to lot size, derived by dividing the total building floor area by the lot size in square feet, yielding a percentage. Zoning District Symbol Floor Area Ratio [FAR] Waterfront Residential WR 0.22 Commercial Moderate/ Intensive CM/ CI 0.3 A. The combined area of all square footage, as measure from exterior walls of all structures on the property, including all floors of the structures, garages, basements and attics with more than five (5) feet of ceiling height and covered porches. Building square footage does not include: Open deck, docks and that portion of covered docks extending over water and one storage shed of one hundred twenty (120) square feet or less. Any additional sheds will be included. (See “FLOOR AREA RATIO”). B. Commercial or industrial: the total area in square feet as measured from the exterior of the outside walls of a building or structure, and when applicable, the sum total of all floor areas of the principal and accessory buildings or structures on the project site. A. Parcel Area ___________________________ sq. ft. B. Existing Floor Area ___________________________ sq. ft. [see above definition] C. Proposed Additional Floor Area ___________________________ sq. ft. D. Proposed Total Floor Area ___________________________ sq. ft. E. Total Allowable Floor Area ___________________________ (Area x _____) [see above table] *If D is larger than E. a variance or revisions to your plan may be needed. Consult with Staff. 5 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 § 179-9-080 Requirements for Site Plan Approval. The Planning Board shall not approve a Site Plan unless it first determines that such site plan meets the following Standards. Please prepare responses to each of the following topics: STANDARDS A. The proposed project furthers or is consistent with the policies of the Town’s Comprehensive Plan. B. The proposed project complies with all other requirements of this Chapter, including the site plan review standards as set forth in Paragraph F of this section, the dimensional, bulk and density regulations of the zoning district in which it is proposed to be located (Article 3 and Table 1), the applicable requirements of all other Articles that apply. C. The site plan encourages pedestrian activity internally and, if practicable, to and from the site with pedestrian paths or sidewalks connected to adjacent areas. D. The site plan must conform to Chapter 136 Sewage and Sewage Disposal, Chapter 147 Stormwater Management Local Law, and other applicable local laws. E. The proposed use shall be in harmony with the general purpose or intent of this Chapter, specifically taking into account the location, character and size of the proposed use and the description and purpose of the district in which such use is proposed, the nature and intensity of the activities to be involved in or conducted in connection with the proposed use and the nature and rate of any increase in the burden on supporting public services and facilities which will follow the approval of the proposed use. F. The establishment, maintenance and operation of the proposed use will not create public hazards from traffic, traffic congestion or the parking of vehicles and/or equipment or be otherwise detrimental to the health, safety or general welfare of persons residing or working in the neighborhood or to the general welfare of the town. Traffic access and circulation, road intersections, road and driveway widths and traffic controls will be adequate. G. Off-street parking and l9oading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be generated by the new use. The establishment of vehicle links between parking areas of adjacent properties are provided where feasible. This furthers the Town’s goal of reducing curb cuts and reducing congestion. A twenty-foot wide connection is required. If adjacent properties are either undeveloped or previously developed without having made provision for future linkage, then a future connection must be identified and provided for in the site plan under review for such future linkage when the time arises. The Planning Board may require proof that the applicant has made contact with adjacent property owners for purposes of coordinating linkages with adjacent properties. H. The project shall not have an undue adverse impact upon the natural, scenic, aesthetic, ecological, wildlife, historic, recreational or open space resources of the town or the Adirondack Park or upon the adequate provision of supporting facilities and services made necessary by the project, taking into account the commercial, industrial, residential, recreational or other benefits that might be derived from the project. In making the determination hereunder, the Planning Board shall consider those factors pertinent to the project contained in the development considerations set forth herein under § 179-9-080 of this Chapter, and in so doing, the Planning Board shall make a net overall evaluation of the project in relation to the development objectives and general guidelines set forth in § 179-9-080 of this Article. I. The provision for and arrangement of pedestrian traffic access and circulation, walkway structures, control of intersections with vehicular traffic and overall pedestrian convenience shall be safe and adequate for pedestrian movement. Pedestrian connections between adjacent sites shall be provided to encourage pedestrian use. J. Stormwater drainage facilities will prevent an increase of post development drainage flows as compared to pre-development drainage flows. Drainage of the site shall recharge ground water to the extent practical. Surface waters flowing off-site shall not degrade any streams or adversely affect drainage on adjacent properties or public roads. Facilities shall be in conformance with the drainage standards of Chapter 147 of the Town Code and the Town of Queensbury Subdivision Regulations where applicable. K. The water supply and sewage disposal facilities will be adequate and will meet all applicable and current requirements set forth by Department of Health regulations and Chapter 136 of the Town Code. L. The adequacy, type and arrangement of trees, shrubs and other suitable plantings, landscaping and screening shall effectively provide a visual and/or noise buffer between the applicants and adjoining lands, including the maximum retention of existing vegetation and maintenance, including replacement of dead or deceased plants. M. Fire lanes, emergency zones and fire hydrants will be adequate and meet the needs and requirements of emergency service providers. N. The design of structures, roadways and landscaping in areas susceptible to ponding, flooding and/or erosion will minimize or avoid such impacts to the maximum extent practicable. O. The site plan conforms to the design standards, landscaping standards and performance standards of this chapter. 6 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 § 179-9-050 Checklist-Application for Site Plan Review. Application materials and site plan shall include sufficient information for the Board to review and provide a decision. The applicant is to provide a site plan drawing and all attachments that address items A-V. The applicant may request a waiver from A-V and is to provide reasons for waiver(s) requested. Please label information to be submitted. REQUIREMENTS Sheet # A. A vicinity map drawn at the scale that shows the relationship of the proposal to existing community facilities which affect or serve it, such as roads, shopping areas, schools, etc. The map shall also show all properties, identify owners, subdivisions, streets and easements within 500 feet of the property. Such a sketch may be superimposed on a United States Geological Survey map of the area. B. The site plan shall be drawn at a scale of forty feet to the inch (1” = 40 feet) or such other scale as the Planning Board may deem appropriate, on standard 24” x 36” sheets, with continuation on 8 l/2 “x 11” sheets as necessary for written information. The information listed below shall be shown on the site plan and continuation sheets. C. Name of the project, boundaries, date, north arrow, and scale of the plan. D. Name and address of the owner of record, developer, and seal of the engineer, architect or landscape architect. If the applicant is not the record owner, a letter of authorization shall be required from the owner. E. The location and use of all existing and proposed structures within the property, including all dimensions of height and floor area, all exterior entrances, and all anticipated future additions and alterations. F. The location of all present and proposed public and private ways, off-street parking areas, driveways, outdoor storage areas, sidewalks, ramps, curbs, paths, landscaping, walls and fences. Location, type and screening details for all waste disposal containers shall also be shown. G. The location, height, intensity and bulb type (sodium, incandescent, etc.) of all external lighting fixtures. The direction of illumination and methods to eliminate glare onto adjoining properties must also be shown in compliance with § 179-6-020. H. The location, height, size, materials and design of all proposed signs. I. The location of all present and proposed utility systems including: 1. Sewage or septic system; 2. Water supply system; 3. Telephone, cable and electrical systems; and 4. Storm drainage system including existing and proposed drain lines, culverts, catch basins, headwalls, endwalls, hydrants, manholes and drainage swales. J. Plans to prevent the pollution of surface or groundwater, erosion of soil both during and after construction, excessive runoff and flooding of other properties, as applicable. A Stormwater Pollution Prevention Plan (SWPPP) for all land development activities (excluding agricultural activities) on the site that results in land disturbance of one acre or more. A SWPPP shall comply with the requirements of the DEC SPDES MS-4 General Permit and Chapter 147 of the Town of Queensbury Code. It shall be at the discretion of the Planning Board as to whether a SWPPP or an erosion and control plan shall be required for a site plan review project land disturbance of less than one acre. K. Existing and proposed topography at two-foot contour intervals, or such other contour interval as the Planning Board shall allow. All elevations shall refer to the nearest United States Coastal and Geodetic Bench Mark. If any portion of the parcel is within the 100-year floodplain, the area will be shown and base flood elevations given. Areas shall be indicated within the proposed site and within 50 feet of the proposed site where soil removal or filling is required, showing the approximate volume in cubic yards. L. A landscape plan showing all existing natural land features than may influence the design of the proposed use such as rock outcrops, stands of trees, single trees eight or more inches in diameter, forest cover and water sources and all proposed changes to these features, including sizes and types of plants. Water sources include ponds, lakes, wetlands and watercourses, aquifers, floodplains and drainage retention areas. M. Land Use District boundaries within 500 feet of the site’s perimeter shall be drawn and identified on the site plan, as well as any Overlay Districts that apply to the property. 7 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 REQUIREMENTS (CONTINUED) Sheet # N. Traffic flow patterns within the site, entrances and exits, loading and unloading areas, as well as curb cuts on the site and within 100 feet of the site. The Planning Board may, at its discretion, require a detailed traffic study for large developments or for those in heavy traffic areas, which shall include: 1. The projected number of motor vehicle trips to enter or leave the site, estimated for weekly and annual peak hour traffic levels; 2. The projected traffic flow pattern including vehicular movements at all major intersections likely to be affected by the proposed use of the site; 3. The impact of this traffic on levels of service on abutting public streets and at affected intersections. Existing and proposed weekly and annual peak hour traffic levels and road capacity levels shall also be given. O. For new construction or alterations to any structure, a table containing the following information shall be included: 1. Estimated area of structure to be used for particular purposes such as retain operation, office, Storage, etc.; 2. Estimated maximum number of employees; 3. Maximum seating capacity, where applicable; and 4. Number of parking spaces existing and required for the intended use. P. 1. Floor Plans. 2. Elevations at a scale of one-quarter inch equals one foot (1/4” = 1 foot) for all exterior facades of the proposed structure(s) and/or alterations to or expansions of existing facades, showing design features and indicating the type and color of materials to be used. Q. Soil logs, water supply well and percolation test results, and storm water runoff calculations as needed to determine and mitigate project impacts. R. Plans for disposal of construction and demolition waste, either on-site or at an approved disposal facility. S. Plans for snow removal, including location(s) of on-site snow storage. T. An Environmental Assessment Form (“EAF”) as required by the SEQRA regulations, with Part 1 completed by the Applicant shall be submitted as part of the application. If the proposed project requires a special use permit and an EAF has been submitted in conjunction with a special use permit application, a duplicate EAF is not required for the site plan application. U. If an application is for a parcel or parcels on which more than one use is proposed, the applicant may submit a single application for all such uses, provided the proposed uses are accurately delineated on a site plan drawn pursuant to the requirements set forth above. The Planning Board may grant the application with respect to some proposed uses and not others. For purposes of reviewing an application (and for SEQRA compliance) all proposed uses on a single parcel or on contiguous parcels shall be considered together. V. A brief narrative statement on how the project proposed for review furthers or is consistent with the vision, goals and policies in the Town’s Comprehensive Plan. 8 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 Town of Queensbury Site Plan Pre-Submission Conference Form / Section 179-9-040 1. Applicant Name: __________________________________________________ 2. Tax Map ID ________________ Location: _______________________ 3. Zoning Classification __________ 4. Reason for Review: __________________________________________________________ 5. Zoning Section #: ________________________ 6. Pre-Submission Meeting Notes: Provided Outstanding; Please provide by Deed ____ _____________ General Information complete ____ _____________ Site Development Data Complete ____ _____________ Setback Requirements Complete ____ _____________ Additional Project Information Complete ____ _____________ FAR addressed ____ _____________ Requirements for Site Plan-Standards ____ _____________ Checklist items addressed ____ _____________ Environmental Form completed ____ _____________ Signature Page completed ____ _____________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Staff Representative: ________________________________ Applicant / Agent: ________________________________ Date: ___________ 9 Site Plan Review application – Revised October 2016 Town of Queensbury Planning Office-742 Bay Road, Queensbury, NY 12804 Signature Page This page includes the 1.) Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.) Authorization for Site Visits; 4.) Other Permit Responsibilities; 5.) Official Meeting Disclosure and 6.) Agreement to provide documentation required. OWNER’S AGENT FORM: Complete the following if the OWNER of the property is not the same as the applicant Owner: ____________________________________ Designates: ____________________________________ As agent regarding: _____ Variance _____ Site Plan _____ Subdivision For Tax Map No.: _____ Section _____ Block _____ Lot Deed Reference: _____ Book _____ Page _____ Date OWNER SIGNATURE: ___________________________________ DATE: _______________ APPLICANT’S AGENT FORM: Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another party: Owner: ____________________________________ Designates: ____________________________________ As agent regarding: _____ Variance _____ Site Plan _____ Subdivision For Tax Map No.: _____ Section _____ Block _____ Lot Deed Reference: _____ Book _____ Page _____ Date OWNER SIGNATURE: ___________________________________ DATE: _______________ 2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design, storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be charged directly to the applicant. Fees for engineering review will not exceed $ 1,000 without notification to the applicant. 3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner, Applicant, and his/her/their agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the subject properties for the purpose of reviewing the application submitted. 4.) OTHER PERMIT RESPONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval by the Zoning Board or Planning Board. It is the applicant’s responsibility to obtain any additional permits. 5.) OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Department to have a designated stenographer tape record the proceedings of meetings resulting from application, and minutes transcribed from those tapes constitutes the official record of all proceedings. 6.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the approved plans and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents, will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy I have read and agree to the above. ____________________________ ___________________________ __________________ Signature [Applicant] Print Name [Applicant] Date signed ____________________________ ___________________________ __________________ Signature [Agent] Print Name [Agent] Date signed Page 1 of 3 Short Environmental Assessment Form Part 1 - Project Information Instructions for Completing Part 1 – Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 – Project and Sponsor Information Name of Action or Project: Project Location (describe, and attach a location map): Brief Description of Proposed Action: Name of Applicant or Sponsor:Telephone: E-Mail: Address: City/PO: State: Zip Code: 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no, continue to question 2. NO YES 2. Does the proposed action require a permit, approval or funding from any other government Agency? If Yes, list agency(s) name and permit or approval: NO YES 3. a. Total acreage of the site of the proposed action? __________ acres b. Total acreage to be physically disturbed? __________ acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? __________ acres Check all land uses that occur on,DUHadjoining RU near the proposed actioQ  8UEDQRural (non-agriculture),ndustrial Commercial Residential (suburban) $TXDWLF2WKHU 6SHFLI\ ƑForest Agriculture ƑParkland Unmanned Communications Facility NYS Route 149, Town of Queensbury, Warren County, New York (portion of SBL 288.8-1-21). Proposed construction of a 260 foot tall (266 feet tall when including the 6 foot lightning rod) self supporting unmanned communications facility. The tower structure will be designed to be capable of supporting multiple antenna arrays. Ata height of 266' AGL, the tower will require FAA aicraft obstruction lighting. The tower and related base station equipment will be enclosed in a 75' x 75' fenced compound. Access to the site will be via a new curb cut from NYS Route 149. A 14 foot wide gravel access road will be constructed to provide access and necessary utilities will be run underground from the State ROW. Tillman Infrastructure 646-578-8428 cwarburton@tillmaninfrastructure.com 152 W. 57th Street New York New York 10019 ✔ FAA - tower registration. FCC - Antenna registration. NYSDOT - curb cut. Queensbury ZBA - Use Variance. Queensbury PB - SUP/SPR. ✔ 2.44 .25 .48 ✔ ✔✔ Page 2 of 3 5. Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape?NO YES 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify: ________________________________________________________________________________ NO YES a. Will the proposed action result in a substantial increase in traffic above present levels? EAre public transportation services available at or near the site of the proposed action? FAre any pedestrian accommodations or bicycle routes available on or near WKHsite of the proposed action? NO YES 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: _____________________________________________________________________________________________ _____________________________________________________________________________________________ NO YES 10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable ZDWHU: _________________________________________ _____________________________________________________________________________________________ NO YES 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: ______________________________________ _____________________________________________________________________________________________ NO YES D'RHVWKHSURMHFWVLWHFRQWDLQRULVLWVXEVWDQWLDOO\FRQWLJXRXVWRDEXLOGLQJDUFKDHRORJLFDOVLWHRUGLVWULFW ZKLFKLVOLVWHGRQWKH1DWLRQDORU6WDWH5HJLVWHURI+LVWRULF3ODFHVRUWKDWKDVEHHQGHWHUPLQHGE\WKH &RPPLVVLRQHURIWKH1<62IILFHRI3DUNV5HFUHDWLRQDQG+LVWRULF3UHVHUYDWLRQWREHHOLJLEOHIRUOLVWLQJRQWKH 6WDWH5HJLVWHURI+LVWRULF3ODFHV" DUFKDHRORJLFDOVLWHVRQWKH1<6WDWH+LVWRULF3UHVHUYDWLRQ2IILFH 6+32 DUFKDHRORJLFDOVLWHLQYHQWRU\" NO YES  D. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain wetlands or other waterbodies regulated by a federal, state or local agency? EWould the proposed action physically alter, or encroach into, any existing wetland or waterbody? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: _____________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ NO YES E,VWKHSURMHFWVLWHRUDQ\SRUWLRQRILWORFDWHGLQRUDGMDFHQWWRDQDUHDGHVLJQDWHGDVVHQVLWLYHIRU ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Page 3 of 3 Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: ƑShoreline ƑForest Agricultural/grasslands Early mid-successional Wetland ƑUrban Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES 16. Is the project site located in the \HDUIlood plan?NO YES 17. Will the proposed action create storm water discharge, either from point or non-point sources? If Yes, a. Will storm water discharges flow to adjacent properties? b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: _____________________________________________________________________________________________ _____________________________________________________________________________________________ NO YES 18. Does the proposed action include construction or other activities that ZRXOGresult in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain WKHpurpose and sizeRIWKHLPSRXQGPHQWBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB ____________________________________________________________________________________________ _ NO YES 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: _______________________________________________________________________________ _____________________________________________________________________________________________ NO YES 20.Has the site of the proposed action or an adjoining property been WKHsubject of remediation (ongoingRU completed)for hazardous waste? If Yes, describe: _______________________________________________________________________________ _____________________________________________________________________________________________ NO YES I &(57,)< THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Date: _____________________Applicant/sponsorname:BBBBBBBBBBBBBBBBBBBBB______________________BBBBBBBBB__________________________ Signature: _____________________________________________________7LWOHBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Stormwater from the access road will be carried in swales to their intersection with the State ROW where the water will enter the existing state highway drainage system. TONY PHILLIPS - FULLERTON ENGINEERING Nov 13, 2019 ZONING & PERMITTING MANAGER PRINT FORM EEAF Mapper Summary Report Wednesday, November 13, 2019 1:51 PM Disclaimer:The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental assessment form (EAF). Not all questions asked in the EAF are answered by the EAF Mapper. Additional information on any EAF question can be obtained by consulting the EAF Workbooks. Although the EAF Mapper provides the most up-to-date digital data available to DEC, you may also need to contact local or other data sources in order to obtain data not provided by the Mapper. Digital data is not a substitute for agency determinations. Part 1 / Question 7 [Critical Environmental Area] No Part 1 / Question 12a [National or State Register of Historic Places or State Eligible Sites] No Part 1 / Question 12b [Archeological Sites] Yes Part 1 / Question 13a [Wetlands or Other Regulated Waterbodies] Yes - Digital mapping information on local and federal wetlands and waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 / Question 15 [Threatened or Endangered Animal] No Part 1 / Question 16 [100 Year Flood Plain] Digital mapping data are not available or are incomplete. Refer to EAF Workbook. Part 1 / Question 20 [Remediation Site] No 1Short Environmental Assessment Form - EAF Mapper Summary Report Page 1 of 2 $JHQF\8VH2QO\>,IDSSOLFDEOH@ 3URMHFW 'DWH 6KRUW(QYLURQPHQWDO$VVHVVPHQW)RUP 3DUW,PSDFW$VVHVVPHQW Part 2 LVWREHFRPSOHWHGE\WKH/HDG$JHQF\ Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept “Have my responses been reasonable considering the scale and context of the proposed action?” No, or small impact may occur Moderate to large impact may occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area (CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a. public / private water supplies? b. public / private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of i mportant historic, archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, waterbodies, groundwater, air quality, flora and fauna)? 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? SEAF 2019 PRINT FORM Page 2 of 2 For every question in Part 2 that was answered “moderate to large impact may occur”, or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting, probability of occurring, duration, irreversibility, geographic scope and magnitude. Also consider the potential for short- term, long-term and cumulative impacts. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. ________________________________________________________________________________________________ Name of Lead Agency Date _________________________________________________ _______________________________________________ Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer _________________________________________________ _______________________________________________ Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) 4IPSU&OWJSPONFOUBM"TTFTTNFOU'PSN 1BSU%FUFSNJOBUJPOPG4JHOJGJDBODF "HFODZ6TF0OMZ<*GBQQMJDBCMF> 1SPKFDU %BUF PRINT FORM § 179-9-080 Requirements for site plan approval. The Planning Board shall not approve a site plan unless it first determines that such site plan meets the following standards: A. The proposed project furthers or is consistent with the policies of the Town's Comprehensive Plan. The proposed project will be consistent with the policies of the Town’s Comprehensive Plan by providing Critical Infrastructure. AT&T will be adding First Net Technology (National First Responders Network) that provides a clear channel to First Responders during emergencies. B. The proposed project complies with all other requirements of this chapter, including the site plan review standards as set forth in Subsection F of this section, the dimensional, bulk, and density regulations of the zoning district in which it is proposed to be located (Article 3 and Table 1), the applicable requirements of all other articles that apply. The proposed project will comply with all applicable standards and requirements. We are working closely with staff to ensure compliance with all regulations. C. The site plan encourages pedestrian activity internally and, if practicable, to and from the site with pedestrian paths or sidewalks connected to adjacent areas. The proposed project will be an unmanned facility and not connected to pedestrian paths or sidewalks. D. The site plan must conform to Chapter 136, Sewage and Sewage Disposal, Chapter 147, Stormwater Management, and other applicable local laws. As referenced above, this will be an unmanned facility with no sewage or sewage disposal. It will conform to local Stormwater Management requirements by providing trenching as needed. We will work closely with staff prior to finalizing construction plans to ensure compliance. E. The proposed use shall be in harmony with the general purpose or intent of this chapter, specifically taking into account the location, character and size of the proposed use and the description and purpose of the district in which such use is proposed, the nature and intensity of the activities to be involved in or conducted in connection with the proposed use and the nature and rate of any increase in the burden on supporting public services and facilities which will follow the approval of the proposed use. The proposed use will be in harmony with the general purpose of this chapter and will not change or increase any burden on public services. The facility will be unmanned and have no impact on public services. F. The establishment, maintenance and operation of the proposed use will not create public hazards from traffic, traffic congestion or the parking of vehicles and/or equipment or be otherwise detrimental to the health, safety or general welfare of persons residing or working in the neighborhood or to the general welfare of the Town. Traffic access and circulation, road intersections, road and driveway widths, and traffic controls will be adequate. Off-street parking and loading facilities will be appropriately located and arranged and sufficient to meet traffic anticipated to be generated by the new use. This is an unmanned facility with no public access. There will be one parking space for use approximately once a month by a technician in a van or small pick-up. We will work closely with staff prior to finalizing construction plans. G. The establishment of vehicle links between parking areas of adjacent properties are provided where feasible. This furthers the Town's goal of reducing curb cuts and reducing congestion. A twenty-foot-wide connection is required. If adjacent properties are either undeveloped or previously developed without having made provision for future linkage, then a future connection must be identified and provided for in the site plan under review for such future linkage when the time arises. The Planning Board may require proof that the applicant has made contact with adjacent property owners for purposes of coordinating linkages with adjacent properties. This section does not apply to the proposed project. There are no adjacent parking areas to be linked. H. The project shall not have an undue adverse impact upon the natural, scenic, aesthetic, ecological, wildlife, historic, recreational or open space resources of the Town or the Adirondack Park or upon the adequate provision of supporting facilities and services made necessary by the project, taking into account the commercial, industrial, residential, recreational or other benefits that might be derived from the project. In making the determination hereunder, the Planning Board shall consider those factors pertinent to the project contained in the development considerations set forth herein under § 179-9-100 of this chapter, and in so doing, the Planning Board shall make a net overall evaluation of the project in relation to the development objectives and general guidelines set forth in § 179-9-100 of this article. The proposed project will not have an undue adverse impact upon the Town or its resources. We have submitted photo simulations as part of the application package that illustrate minimal visual impact. (Exhibit J) I. The provision for and arrangement of pedestrian traffic access and circulation, walkway structures, control of intersections with vehicular traffic and overall pedestrian convenience shall be safe and adequate for pedestrian movement. Pedestrian connections between adjacent sites shall be provided to encourage pedestrian use. The proposed facility will be unmanned with no adjacent sites and none are planned. J. Stormwater drainage facilities will prevent an increase of post-development drainage flows as compared to predevelopment drainage flows. Drainage of the site shall recharge groundwater to the extent practical. Surface waters flowing off-site shall not degrade any streams or adversely affect drainage on adjacent properties or public roads. Facilities shall be in conformance with the drainage standards of Chapter 147 of the Town Code and the Town of Queensbury Subdivision Regulations,[1] where applicable. The proposed facility will be in conformance with required drainage standards of Chapter 147 of the Town Code by providing trenching as needed. We will work closely with staff towards a satisfactory final design. K. The water supply and sewage disposal facilities will be adequate and will meet all applicable and current requirements set forth by Department of Health regulations and Chapter 136 of the Town Code. The proposed project does not require nor include any water or sewage facility. There will be no impact on Town Facilities. L. The adequacy, type and arrangement of trees, shrubs and other suitable plantings, landscaping and screening shall effectively provide a visual and/or noise buffer between the applicants and adjoining lands, including the maximum retention of existing vegetation and maintenance, including replacement of dead or diseased plants. The proposed project will utilize existing screening in addition to meeting the screening standards set forth in the Town Code. We have attached photo simulations Exhibit J. M. Fire lanes, emergency zones and fire hydrants will be adequate and meet the needs and requirements of emergency service providers. The proposed unmanned facility will meet the applicable needs and requirements of emergency service providers. We will work closely with the Fire Marshall to ensure the requirements are met. Additionally, the proposed facility will include First Net technology. The National First Responders Network. N. The design of structures, roadways and landscaping in areas susceptible to ponding, flooding and/or erosion will minimize or avoid such impacts to the maximum extent practicable. The proposed facility will be designed to limit the impact of ponding, flooding and/or erosion. We will work closely with staff to avoid impacts to the maximum extent practical. O. The site plan conforms to the design standards, landscaping standards and performance standards of this chapter The proposed Site Plan will conform to the design, landscaping, and performance standards of this chapter. We will be working closely with staff to meet all design, landscaping and performance standards. Existing AT&T coverage at 195’ rad and 561’ GE, Proposed AT&T coverage at 250’ rad and 524’ GE TOWER INVENTORY WITHIN 2 MILES Available towers do not meet RF requirements for AT&T to equal existing or better service. Please note: AT&T Currently Tenant on below SBA Tower that does not appear in searches.               ! " # $%$$%& '((()**+,-. ./0.++,0./1-2                   !"!#! $%&    !"!#! $%& !# ''   !# '  ('' !"!#! $%& !# ''  '               ! " # $%$$%& '((()**+,-. ./0.++,0./1-2)   !"!#! $%&)  '*+&&,&*))                  ! " # $%$$%& '((()**+,-. ./0.++,0./1-2)   !"!#! $%& '*+&,&*) !! 3   ! 3  &   & !  &     " 3        & &           "     3   " ! 3   "   & 3   " & ' #%" && 4 "!"!!  " "!    3 5&6 7 4 ""3"& ""  4 &  "!     8 && !  "  !6 7'   & 8  384   #   %   !3    !3 "  3 !3    3 && 4            "" !"! !                   " 6 7 5&  " !        !"  3  5&  4 " 4   !      "" "39 "!&  "  " "!    !   "  3  4     &  &    " !              3     8 & &   ! & &  !        ""39  6 7  &6 7 5   & "    8      3  !       3                        ! " # $%$$%& '((()**+,-. ./0.++,0./1-2)   !"!#! $%&  ! '%*+,&*)  !                ! " # $%$$%& '((()**+,-. ./0.++,0./1-2)   !"!#! $%& '-*+,&*)                E‐911 Address Verification Form    Fullerton Engineering, on behalf of Tillman Infrastructure, LLC is requesting an E‐911 address for a new  cell tower that they will be building.  Please provide the address and contact information from the  coordinates provided below.     Date: 2/7/19  To: Queensbury E911 Addressing  From: Fullerton Engineering, Suzanne Brow      Site Name/RELO #_FA #: 14731229_TI‐OPP‐13154  1‐A Latitude: 43.3716689  1‐A Longitude: ‐73.6935038  Owner: BURKE BROTHERS BUILDERS, INC  Parcel#:  288.8‐1‐21    State Route 149, Queensbury, NY 12845 Warren County      Assigned E‐911 Address:  55 State Route 149, Lake George, NY 12845  Governing E‐911 Authority: Queensbury E911 Address  Contact Name:  David Hatlin  codes@queensbury.net  Contact Phone Number: 518‐761‐8253    NOTE:  It is imperative that the address given above is used EXACTLY as it is issued.  Do not spell out  words that are abbreviated.      Suzanne Brow  Site Acquisition Specialist  sbrow@fullertonEngineering.com  Direct # 732‐773‐7073  Standards for Placement § 179-5-130 Wireless telecommunication facilities and infrastructure. [Amended 1-28-2011 by L.L. No. 2-2011; 4-8-2019 by L.L. No. 2-2019] I. Standards for placement. New or modified antennas or telecommunications towers shall be placed according to the following priority: first, collocation on an existing tower; second, placement of antennas or other telecommunications equipment in or on an existing tall structure located on a lot within the areas listed in Subsection C above; third, placement in or on an existing tall structure not located within the areas listed in Subsection C above; fourth, placement of a new tower on a lot where a telecommunications tower already exists; and fifth, placement of a new tower on a lot within the areas listed in Subsection C above. Where shared use of existing towers or structures is not proposed, the applicant must provide documentation of the inability to utilize an existing tower or structure. (4) New telecommunications towers on lots not already containing a tower. Construction of a new telecommunications tower on a lot not already containing a telecommunications tower shall be given fourth priority after co-location on existing towers, shared use of existing tall structures and construction of a tower on a lot already containing a tower. The Planning Board may consider a new telecommunications tower on a lot not already containing a telecommunications tower when: (a) The applicant documents that co-location on an existing telecommunications tower, shared use of an existing tall structure and locating the tower on a lot already having a telecommunications tower are not practical. The only tower within the geographical requirements provided to us by AT&T is the tower they currently occupy at 150 feet. AT&T has attempted to negotiate with current tower owner. (See attached Exhibit M) No other towers that meet the geographical requirement with regards to elevation and location were found. (See attached Exhibit G) [1] The applicant shall submit a report locating and inventorying all existing tall structures and existing or approved telecommunications towers within a reasonable distance of the proposed site. This distance shall be determined by the Planning Board in consultation with the applicant. See attached report Available Towers within 2 Miles (Exhibit G). Current technology requires antennas/towers to be located much closer than before for capacity and coverage. Our client requested a 1500 foot search ring and 250 foot elevation. No structures on the list qualify. [2] The applicant shall document good faith efforts to secure shared use from the owner of each existing tall structure, existing or approved telecommunications tower and lot already containing a telecommunications tower. Such documentation shall include written requests to each owner, estimated expenses and an explanation of the physical, technical and/or financial reasons why co-location on an existing telecommunications tower, shared use of an existing tall structure or location on a lot already containing a tower is not practical in each case. The only tower that could possibly meet the location is the tower AT&T already occupies. AT&T has made attempts to renegotiate their Lease Agreement prior to the renewal. (See attached Exhibit M). Additionally, AT&T RF Engineers have determined a RAD Center of 250’ is needed. To provide optimum coverage. Current RAD is 150’. (b) The applicant submits a copy of the Federal Communications Commission (FCC) license for operation of the new equipment. As previously stated, AT&T currently occupies space on the adjacent tower at 150’. Their License for Operation should already be on file with the Town of Queensbury. We can provide updated documentation upon request. 27271 Las Ramblas, Suite 300 Mission Viejo, CA 92691 January 13, 2018 SBA Corporation Site Administration 8051 Congress Avenue Boca Raton, FL 33487-1310 Re: AT&T Cell Site Lease –61 NYS ROUTE 149 QUEENSBURY NY| FA: 10001040| Site Name: QUEENSBURY Dear Landlord, AT&T is in a very competitive space and we need to ensure that our lease terms and conditions are supportive of our current and future needs. AT&T has the option to either extend or terminate the above referenced lease (“Lease”) in approximately three years. AT&T is instituting a new program to evaluate terms and conditions of all leases coming up for renewal, explore advance renegotiation options and consider possible alternative site locations. Our first choice is to create a new agreement that serves both parties well. Conditions we desire to implement in all new “go forward” leases include: • “Real Estate Rights”: In its simplest form, a lease right to utilize the entire RAD center without any “per touch” rent upcharges. • Rents reduced to competitive rates. • Reduced or no annual escalators (depending on other terms of the overall new deal). • “Fair” early termination rights. As you know, it takes time to negotiate, plan and execute a site relocation. That is why the AT&T’s review process is starting now. Please review the specifics of our Lease agreement and advise if you are willing to enter into discussions regarding a new, modified contract. For new terms consistent with the above, AT&T will in turn consider additional term extensions. AT&T will appreciate a reply within 60 days of receipt of this letter. A “no” or non-response will trigger AT&T’s review of alternate locations. A positive response will be appreciated, but satisfactory terms and conditions negotiations must conclude within 90 days or AT&T will continue to evaluate alternative site locations. Responses may be emailed, standard mail, or a call as designated below. Please reference FA number 10001040 in your response so that AT&T may ensure your response is documented accordingly. AT&T values its association with you and looks forward to continui ng this relationship for the long term. Sincerely, Gram Meadors AVP – Contract/Sourcing Ops Email Responses to: g04000@att.com with a Subject line of Partnership – FA 10001040 Mail Responses to: AT&T Cell Site Partnership 2423 FA 10001040 Rm 12D67 575 Morosgo Dr. NE Atlanta, GA 30324-3300 Telephone Number 866-354-5888 Mail Processing Center Federal Aviation Administration Southwest Regional Office Obstruction Evaluation Group 10101 Hillwood Parkway Fort Worth, TX 76177 Aeronautical Study No. 2019-AEA-1776-OE Page 1 of 4 Issued Date: 03/28/2019 Donna-Marie Stipo Tillman Infrastructure, LLC 152 West 57th Street 8th Floor New York, NY 10019 ** DETERMINATION OF NO HAZARD TO AIR NAVIGATION ** The Federal Aviation Administration has conducted an aeronautical study under the provisions of 49 U.S.C., Section 44718 and if applicable Title 14 of the Code of Federal Regulations, part 77, concerning: Structure:Monopole Queensbury NY – TI-13154 Location:Queensbury, NY Latitude:43-22-18.00N NAD 83 Longitude:73-41-36.61W Heights:528 feet site elevation (SE) 185 feet above ground level (AGL) 713 feet above mean sea level (AMSL) This aeronautical study revealed that the structure does not exceed obstruction standards and would not be a hazard to air navigation provided the following condition(s), if any, is(are) met: Based on this evaluation, marking and lighting are not necessary for aviation safety. However, if marking/ lighting are accomplished on a voluntary basis, we recommend it be installed in accordance with FAA Advisory circular 70/7460-1 L Change 2. This determination expires on 09/28/2020 unless: (a)the construction is started (not necessarily completed) and FAA Form 7460-2, Notice of Actual Construction or Alteration, is received by this office. (b)extended, revised, or terminated by the issuing office. (c)the construction is subject to the licensing authority of the Federal Communications Commission (FCC) and an application for a construction permit has been filed, as required by the FCC, within 6 months of the date of this determination. In such case, the determination expires on the date prescribed by the FCC for completion of construction, or the date the FCC denies the application. NOTE: REQUEST FOR EXTENSION OF THE EFFECTIVE PERIOD OF THIS DETERMINATION MUST BE E-FILED AT LEAST 15 DAYS PRIOR TO THE EXPIRATION DATE. AFTER RE-EVALUATION OF CURRENT OPERATIONS IN THE AREA OF THE STRUCTURE TO DETERMINE THAT NO Page 2 of 4 SIGNIFICANT AERONAUTICAL CHANGES HAVE OCCURRED, YOUR DETERMINATION MAY BE ELIGIBLE FOR ONE EXTENSION OF THE EFFECTIVE PERIOD. This determination is based, in part, on the foregoing description which includes specific coordinates, heights, frequency(ies) and power. Any changes in coordinates, heights, and frequencies or use of greater power, except those frequencies specified in the Colo Void Clause Coalition; Antenna System Co-Location; Voluntary Best Practices, effective 21 Nov 2007, will void this determination. Any future construction or alteration, including increase to heights, power, or the addition of other transmitters, requires separate notice to the FAA.This determination includes all previously filed frequencies and power for this structure. If construction or alteration is dismantled or destroyed, you must submit notice to the FAA within 5 days after the construction or alteration is dismantled or destroyed. This determination does include temporary construction equipment such as cranes, derricks, etc., which may be used during actual construction of the structure. However, this equipment shall not exceed the overall heights as indicated above. Equipment which has a height greater than the studied structure requires separate notice to the FAA. This determination concerns the effect of this structure on the safe and efficient use of navigable airspace by aircraft and does not relieve the sponsor of compliance responsibilities relating to any law, ordinance, or regulation of any Federal, State, or local government body. A copy of this determination will be forwarded to the Federal Communications Commission (FCC) because the structure is subject to their licensing authority. If we can be of further assistance, please contact our office at (817) 222-5932, or joan.tengowski@faa.gov. On any future correspondence concerning this matter, please refer to Aeronautical Study Number 2019-AEA-1776- OE. Signature Control No: 397817357-400917775 ( DNE ) Joan Tengowski Technician Attachment(s) Frequency Data Map(s) cc: FCC Page 3 of 4 Frequency Data for ASN 2019-AEA-1776-OE LOW FREQUENCY HIGH FREQUENCY FREQUENCY UNIT ERP ERP UNIT 614 698 MHz 2000 W 614 698 MHz 1000 W 698 806 MHz 1000 W 806 824 MHz 500 W 806 901 MHz 500 W 824 849 MHz 500 W 851 866 MHz 500 W 869 894 MHz 500 W 896 901 MHz 500 W 901 902 MHz 7 W 929 932 MHz 3500 W 930 931 MHz 3500 W 931 932 MHz 3500 W 932 932.5 MHz 17 dBW 935 940 MHz 1000 W 940 941 MHz 3500 W 1670 1675 MHz 500 W 1710 1755 MHz 500 W 1850 1910 MHz 1640 W 1850 1990 MHz 1640 W 1930 1990 MHz 1640 W 1990 2025 MHz 500 W 2110 2200 MHz 500 W 2305 2360 MHz 2000 W 2305 2310 MHz 2000 W 2345 2360 MHz 2000 W Page 4 of 4 TOPO Map for ASN 2019-AEA-1776-OE