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HomeMy WebLinkAboutSP201300003 Application 2013-02-05 Albemarle Cow,,.ty Community Development Department 40Intire Road Charlottesville,VA 22902-4596 # " Planning Application Voice:(434)296-5832 Fax:(434)972-4126 PARCEL/ OWNER INFORMATION TMP) 09200-00-00-005A0 Owner(s): Application # SP201300003 ORROCK, IEANNETTE S PROPERTY INFORMATION Legal Description ACREAGE GOBBLER RIDGE Magisterial Dist. Scottsville Land Use Primary Residential --Single-family(incl. modular homes) Current AFD Not in A/F District Current Zoning Primary Rural Areas APPLICATION INFORMATION Street Address 1238 THOMAS JEFFERSON PKWY CHARLOTTESVILLE, 22902 Entered By Application Type Special Use Permit Todd Shiffilett 102/05/2013 Project Iverizon Wireless- "Simeon"/Orrock Property Received Date 02/04/13 Received Date Final I Submittal Date 02/19/13 Total Fees 2000 Closing File Date Submittal Date Final Total Paid 2000 Revision Number Comments A^6 ©K Legal Ad SUB APPLICATION(s) Type I Sub Applicati C Comment Personal Wireless Facili SR . _._ . ty` ._02/1Zf13:_ (APPLICANT/ CONTACT INFORMATION ContactType IaRROCK,7EANNk Name. _ Address f CityState Zip Phone PhoneCell Owner/Applicant ry 1241) THOMAS JEFfERS7) PK € HARLOTT'ESViLt 32291)2 Primary Contact STEPHEN WALLER,AICP 536 PANTOPS CENTER - PMB CHARLOTTESVILL 22911 4348250617 Signature of Contractor or Authorized Agent Date FOR OFFICE USE ONLY Application#_ SIGN#(if an SP Fee Amount$2/:60 Date PaidL C' 1 / nCReceipt#Litire0 Ck# 1L1( By: J) 11 6// ZONING ORDINANCE SECTION Application for Personal Wireless Service Facility ;m RGRSP IMPORTANT: Your application is considered INCOMPLETE until all of the information on the Required Application Content Checklist on pages 2 thru 4 has been submitted and the appropriate fee has been submitted. (See page 9 for the appropriate fee(s)related to your application). Staff will assist you with these items. PROJECT NAME: (how should we refer to this application?): Verizon Wireless-"Simeon"/Orrock Property PROPOSAL: Tier I ❑ Tier II ❑ Tier III 181 Building Permit after Tier II or Tier III approval ❑ EXISTING COMP PLAN LAND USE/DENSITY: Rural Areas 4 LOCATION/ADDRESS OF PROPERTY FOR SPECIAL USE PERMIT: 1240 Thomas Jefferson Road CO-LOCATED? YES ❑ NO 181 TAX MAP PARCEL(s): 09200-00-00-005A0 ZONING DISTRICT: Rural Areas MAGISTERIAL DISTRICT: Scottsville #OF ACRES TO BE COVERED BY SPECIAL USE PERMIT(if a portion it must be delineated on a plat): 15.61 Is this an amendment to an existing Special Use Permit?If Yes provide that SP Number. ❑YES ®NO Are you submitting any waivers with this application? ❑ YES ®NO Applicant(Who should we call/write concerning this project?): Verizon Wireless-C/O Stephen Waller,AICP Address 536 Pantops Center-PMB#405 City Charlottesville State VA Zip 22911 Daytime Phone(434)825-0617 Fax#(757)282-5811 E-mail stephen.waller @gdnsites.com The applicant is a representative of: Cellco Partnership d/b/a Verizon Wireless Owner of Record Jeannette S. Orrock Address 1240 Thomas Jefferson City Charlottesville State VA Zip 22902 Daytime Phone(434) 977-5340 Fax#( ) -.. E-mail Contractor(Building Permits and Tier I only) Address City State Zip Daytime Phone( ) Fax#( ) E-mail Does the owner of this property own(or have any ownership interest in)any abutting property? If yes,please list those tax map and parcel numbers: FOR OFFICE USE ONLY History: ❑ Special Use Permits: ❑ ZMAs&Proffers: ❑ Variances: Letter of Authorization ❑YES ❑NO Tier 1=Building Permit Tier II=Site Plan Tier III=Special Use Permit County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 This form created 2/15/12 Page 1 of 9 REQUIRED ATTACHMENTS '1' '"` This form provides information on: 1. Required application content checklist 2. Design and review criterion 3. Waiver criteria 4. Definitions associated with Personal Wireless Service Facilities Required Application Content Checklist for Tier I, Tier II and Tier III Each request for approval of a facility shall include the following information: XI 17 copies of supporting plans/plats are required for Tier II and Tier III applications. (TIER II AND TIER III APPLICATIONS ONLY) ❑ 2 copies of supporting plans/plats are required for Tier I and Building Permit Applications. (TIER I AND BUILDING PERMIT APPLICATIONS ONLY) >SI A completed application form, signed by the parcel owner,the parcel owner's agent or the contract purchaser,and the proposed facility's owner. If the owner's agent signs the application, he shall also submit written evidence of the existence and scope of the agency.If the contract purchaser signs the application,he shall also submit the owner's written consent to the application. A recorded plat or recorded boundary survey of the parcel on which the facility will be located;provided,if neither a recorded plat nor boundary survey exists,a copy of the legal description of the parcel and the Albemarle County Circuit Court deed book and page number. $1 The identity of the owner of the parcel and, if the owner is other than a real person,the complete legal name of the entity,a description of the type of entity,and written documentation that the person signing on behalf of the entity is authorized to do so. 1?SI Except where the facility will be located entirely within an existing structure,a scaled plan and a scaled elevation view and other supporting drawings,calculations,and other documentation required by the agent, signed and sealed by an appropriate licensed professional.The plans and supporting drawings,calculations and documentation shall show: $1 The location and dimensions of all existing and proposed improvements on the parcel including access roads and structures,the location and dimensions of significant natural features,and the maximum height above ground of the facility(also identified in height above sea level). • The benchmarks and datum used for elevations.The datum shall coincide with the Virginia State Plane Coordinate System, South Zone,North American Datum of 1983 (NAD83), United States Survey Feet North American Vertical Datum of 1988 (NAVD88),and the benchmarks shall be acceptable to the county engineer. 1331 The design of the facility, including the specific type of support structure and the design,type, location, size,height and configuration of all existing and proposed antennas and other equipment. • Identification of each paint color on the facility,by manufacturer color name and color number. A paint chip or sample shall be provided for each color. This form created 2/15/12 Page 2 of 9 181 Except where the facility would be attached to an existing structure,the topography within two thousand(2,000)feet of the proposed facility,in contour intervr -t to exceed ten(10)feet for all lands within P marle County and, in contour intervals shown on United States Geological w.rvey topographic survey maps or the best topog,.e hic data available,for lands not within Albemarle County. (NOT REQUIRED FOR A TIER I FACILITY) • The height,caliper and species of all trees where the dripline is located within fifty(50)feet of the facility that are relied upon to establish the proposed height and/or screening of the monopole.All trees that will be adversely impacted or removed during installation or maintenance of the facility shall be noted,regardless of their distances to the facility. ]81 All existing and proposed setbacks,parking, fencing and landscaping. • The location of all existing accessways and the location and design of all proposed accessways. • Except where the facility would be attached to an existing structure,residential and commercial structures,and residential and rural areas zoning district boundaries. (NOT REQUIRED FOR A TIER I FACILITY) ❑ If the proposed tower will be taller than one hundred fifty(150)feet,the proximity of the facility to commercial and private airports. (NOT REQUIRED FOR A TIER I FACILITY) N/A • Photographs,where possible, or perspective drawings of the facility site and all existing facilities within two hundred(200)feet of the site,if any,and the area surrounding the site. ❑ For any proposed monopole or tower,photographs taken of a balloon test,which shall be conducted as follows: (NOT REQUIRED FOR A TIER I FACILITY) TO BE SCHEDULED WITH REVIEW STAFF ❑ The applicant shall contact the agent within ten(10)days after the date the application was submitted to schedule a date and time when the balloon test will be conducted.The test shall be conducted within forty(40)days after the date the application was submitted,and the applicant shall provide the agent with at least seven(7)days prior notice;provided that this deadline may be extended due to inclement weather or by the agreement of the applicant and the agent. (NOT REQUIRED FOR A TIER I FACILITY) ❑ Prior to the balloon test,the locations of the access road,the lease area,the tower site,the reference tree and the tallest tree within twenty five(25)feet of the proposed monopole shall be surveyed and staked or flagged in the field. (NOT REQUIRED FOR A TIER I FACILITY) ❑ The test shall consist of raising one or more balloons from the site to a height equal to the proposed facility. (NOT REQUIRED FOR A TIER I FACILITY) ❑ The balloons shall be of a color or material that provides maximum visibility. (NOT REQUIRED FOR A TIER I FACILITY) ❑ The photographs of the balloon test shall be taken from the nearest residence and from appropriate locations on abutting properties,along each publicly used road from which the balloon is visible,and other properties and locations as deemed appropriate by the agent. The applicant shall identify the camera type,film size,and focal length of the lens for each photograph. (NOT REQUIRED FOR A TIER I FACILITY) ❑ If antennas are proposed to be added to an existing structure,all existing antennas and other equipment on the structure,as well as all ground equipment,shall be identified by owner,type and size. The method(s)by which the antennas will be attached to the mounting structure shall be depicted. (NOT REQUIRED FOR A TIER II OR TIER III FACILITY) This form created 2/15/12 Page 3 of 9 $1 If the proposed facility would be lo' d on lands subject to a conservation easement 'n open space easement,a copy of the recorded deed of easement and the o.press written consent of all easement holders to...eproposed facility. N/A )�I If the facility is to be located closer in distance than the height of the tower or other mounting structure to any lot line the applicant must submit an easement or other recordable document showing agreement between the lot owners,acceptable to the county attorney addressing development on the part of the abutting parcel sharing the common lot line that is within the facility's fall zone(e.g.,the setback of an eighty(80)foot-tall facility could be reduced to thirty(30)feet if an easement is established prohibiting development on the abutting lot within a fifty(50)foot fall zone). If the right-of-way for a public street is within the fall zone,the Virginia Department of Transportation shall be included in the staff review, in lieu of recording an easement or other document. (NOT REQUIRED FOR A TIER I FACILITY) B1 Notwithstanding section 32.2 of this chapter,a site plan shall not be required for a facility,but the facility shall be subject to the requirements of section 32 and the applicant shall submit all schematics,plans,calculations,drawings and other information required by the agent to determine whether the facility complies with section 32. In making this determination,the agent may impose reasonable conditions authorized by section 32 in order to assure compliance. N/A Prior to issuance of a building permit,the applicant shall submit a tree conservation plan prepared by a certified arborist. The plan shall be submitted to the agent for review and approval to assure that all applicable requirements have been satisfied. The plan shall specify tree protection methods and procedures,and identify all existing trees to be removed on the parcel for the installation,operation and maintenance of the facility. Except for the tree removal expressly authorized by the agent,the applicant shall not remove existing trees within the lease area or within one hundred(100)feet in all directions surrounding the lease area of any part of the facility. In addition,the agent may identify additional trees or lands up to two hundred(200) feet from the lease area to be included in the plan. (TIER I FACILITIES AND BUILDING PERMITS ONLY) The following shall be submitted with the building permit application: (i)certification by a registered surveyor stating the height of the reference tree that is used to determine the permissible height of the monopole;and(ii)a final revised set of plans for the construction of the facility. The agent shall review the surveyor's certificate and the plans to assure that all applicable requirements have been satisfied. (REQUIRED ONLY AT TIME OF BUILDING PERMIT APPLICATION) Design and review criterion The following regulations are taken from Chapter 18, Section 5.1.40 of the Code of Albemarle. c. Tier I facilities. Each Tier I facility may be established upon approval of an application satisfying the requirements of subsection 5.1.40(a)by the agent,demonstrating that the facility will be installed and operated in compliance with all applicable provisions of this chapter,satisfying all conditions of the architectural review board,and meeting the following conditions: 1.The facility shall comply with subsection 5.1.40(b). 2.The facility shall be designed,constructed and maintained as follows: (i)guy wires shall not be permitted;(ii)outdoor lighting for the facility shall be permitted only during maintenance periods;regardless of the lumens emitted,each outdoor luminaire shall be fully shielded as required by section 4.17 of this chapter;(iii)any equipment cabinet not located within the existing structure shall be screened from all lot lines either by terrain,existing structures,existing vegetation,or by added vegetation approved by the county's landscape planner;(iv)a whip antenna less than six(6)inches in diameter may exceed the height of the existing structure;(v)a grounding rod,whose height shall not exceed two(2)feet and whose width shall not exceed one(1)inch in diameter at the base and tapering to a point,may be installed at the top of facility or the structure;and(vi)within one month after the completion of the installation of the facility,the applicant shall provide a statement to the agent certifying that the height of all components of the facility complies with this regulation. 3. Equipment shall be attached to the exterior of a structure only as follows: (i)the total number of arrays of antennas attached to the existing structure shall not exceed three(3),and each antenna proposed to be attached under the pending application shall not exceed the size shown on the application,which size shall not exceed one thousand one hundred fifty two(1152)square inches; (ii)no antenna shall project from the structure beyond the minimum required by the mounting equipment,and in no case shall any point on the face of an antenna project more than twelve(12)inches from the existing structure;and(iii)each antenna and associated equipment shall be a color that matches the existing structure. For purposes of this section,all types of antennas and dishes regardless of their use shall be counted toward the limit of three arrays. This form created 2/15/12 Page 4 of 9 4. Prior to issuance of a building permit,the applicant shall submit a tree conservation nlan prepared by a certified arborist.The plan shall be submitted to the agent_ •eview and approval to assure that all applical ;quirements have been satisfied. The plan shall specify tree protection me$T6'ds and procedures,and identify all existing treo be removed on the parcel for the installation,operation and maintenance of the facility. Except for the tree removal expressly authorized by the agent,the applicant shall not remove existing trees within the lease area or within one hundred(100)feet in all directions surrounding the lease area of any part of the facility. In addition,the agent may identify additional trees or lands up to two hundred(200) feet from the lease area to be included in the plan. 5.The installation,operation and maintenance of the facility shall be conducted in accordance with the tree conservation plan. Dead and dying trees identified by the arborist's report may be removed if so noted on the tree conservation plan.If tree removal is later requested that was not approved by the agent when the tree conservation plan was approved,the applicant shall submit an amended plan.The agent may approve the amended plan if the proposed tree removal will not adversely affect the visibility of the facility from any location off of the parcel. The agent may impose reasonable conditions to assure that the purposes of this paragraph are achieved. 6.The facility shall be disassembled and removed from the site within ninety(90)days of the date its use for personal wireless service purposes is discontinued. If the agent determines at any time that surety is required to guarantee that the facility will be removed as required,the agent may require that the parcel owner or the owner of the facility submit a certified check,a bond with surety,or a letter of credit, in an amount sufficient for,and conditioned upon,the removal of the facility.The type and form of the surety guarantee shall be to the satisfaction of the agent and the county attorney. In determining whether surety should be required,the agent shall consider the following: (i)the annual report states that the tower or pole is no longer being used for personal wireless service facilities;(ii)the annual report was not filed;(iii)there is a change in technology that makes it likely that tower or pole will be unnecessary in the near future;(iv)the permittee fails to comply with applicable regulations or conditions;(v)the permittee fails to timely remove another tower or pole within the county;and(vi)whenever otherwise deemed necessary by the agent. 7.The owner of the facility shall submit a report to the agent by no earlier than May or and no later than July 1 of each year.The report shall identify each user of the existing structure,and include a drawing,photograph or other illustration identifying which equipment is owned and/or operated by each personal wireless service provider. Multiple users on a single tower or other mounting structure may submit a single report,provided that the report includes a statement signed by a representative from each user acquiescing in the report. 8.No slopes associated with the installation of the facility and accessory uses shall be created that are steeper than 2:1 unless retaining walls,revetments,or other stabilization measures acceptable to the county engineer are employed. 9.Any equipment cabinet not located within an existing building shall be fenced only with the approval of the agent upon finding that the fence: (i)would protect the facility from trespass in areas of high volumes of vehicular or pedestrian traffic or, in the rural areas,to protect the facility from livestock or wildlife;(ii)would not be detrimental to the character of the area; and(iii) would not be detrimental to the public health,safety or general welfare. d. Tier II facilities. Each Tier II facility may be established upon commission approval of an application satisfying the requirements of subsection 5.1.40(a)and demonstrating that the facility will be installed and operated in compliance with all applicable provisions of this chapter,criteria(1)through(8)below,and satisfying all conditions of the architectural review board.The commission shall act on each application within the time periods established in section 32.4.2.6.The commission shall approve each application,without conditions, once it determines that all of these requirements have been satisfied. If the commission denies an application, it shall identify which requirements were not satisfied and inform the applicant what needs to be done to satisfy each requirement. 1.The facility shall comply with subsection 5.1.40(b)and subsection 5.1.40(c)(2)through(9). 2.The site shall provide adequate opportunities for screening and the facility shall be sited to minimize its visibility from adjacent parcels and streets,regardless of their distance from the facility. If the facility would be visible from a state scenic river or a national park or national forest,regardless of whether the site is adjacent thereto,the facility also shall be sited to minimize its visibility from such river,park or forest. If the facility would be located on lands subject to a conservation easement or an open space easement,or adjacent to a conservation easement or open space easement,the facility shall be sited so that it is not visible from any resources specifically identified for protection in the deed of easement. 3.The facility shall not adversely impact resources identified in the county's open space plan. 4.The facility shall not be located so that it and three(3)or more existing or approved personal wireless service facilities would be within an area comprised of a circle centered anywhere on the ground having a radius of two hundred(200)feet. This form created 2/15/12 Page 5 of 9 5.The maximum base diameter of the monopole shall be thirty(30)inches and the maY;mum diameter at the top of the monopole shall be eighteen(18)inc._ v.✓ 6.The top of the monopole,measured in elevation above mean sea level, shall not exceed the height approved by the commission.The approved height shall not be more than seven(7)feet taller than the tallest tree within twenty-five(25)feet of the monopole,and shall include any base,foundation or grading that raises the pole above the pre-existing natural ground elevation;provided that the height approved by the commission may be up to ten(10)feet taller than the tallest tree if the owner of the facility demonstrates to the satisfaction of the commission that there is not a material difference in the visibility of the monopole at the proposed height,rather than at a height seven(7)feet taller than the tallest tree;and there is not a material difference in adverse impacts to resources identified in the county's open space plan caused by the monopole at the proposed height,rather than at a height seven(7)feet taller than the tallest tree. The applicant may appeal the commissioner's denial of a modification to the board of supervisors as provided in subsection 5.1.40(d)(12). 7. Each wood monopole shall be a dark brown natural wood color;each metal or concrete monopole shall be painted a brown wood color to blend into the surrounding trees.The antennas,supporting brackets,and all other equipment attached to the monopole shall be a color that closely matches that of the monopole.The ground equipment,the ground equipment cabinet,and the concrete pad shall also be a color that closely matches that of the monopole,provided that the ground equipment and the concrete pad need not be of such a color if they are enclosed within or behind an approved structure,façade or fencing that: (i)is a color that closely matches that of the monopole;(ii) is consistent with the character of the area;and(iii)makes the ground equipment and concrete pad invisible at any time of year from any other parcel or a public or private street. 8. Each wood monopole shall be constructed so that all cables, wiring and similar attachments that run vertically from the ground equipment to the antennas are placed on the pole to face the interior of the property and away from public view,as determined by the agent. Metal monopoles shall be constructed so that vertical cables,wiring and similar attachments are contained within the monopole's structure. 9.The following shall be submitted with the building permit application: (i)certification by a registered surveyor stating the height of the reference tree that is used to determine the permissible height of the monopole;and(ii)a final revised set of plans for the construction of the facility. The agent shall review the surveyor's certificate and the plans to assure that all applicable requirements have been satisfied. 10.The following shall be submitted to the agent after installation of the monopole is completed and prior to issuance of a certificate of occupancy: (i)certification by a registered surveyor stating the height of the monopole,measured both in feet above ground level and in elevation above mean sea level, using the benchmarks or reference datum identified in the application;and (ii)certification stating that the lightning rod's height does not exceed two(2)feet above the top of the monopole and width does not exceed a diameter of one(1)inch. 11.Notice of the commission's consideration of an application for a Tier II facility shall be sent by the agent to the owner of each lot abutting the lot on which the proposed facility will be located.The notice shall describe the nature of the facility, its proposed location on the lot, its proposed height,the appropriate county office where the complete Tier II facility application may be viewed,and the date,time and location where the commission will consider the application. The notice shall be mailed by first class mail or hand delivered at least ten(10)days prior to the commission meeting. Mailed notice shall be mailed to the last known address of the owner,and mailing the notice to the address shown on the current real estate tax assessment records of the county shall be deemed compliance with this requirement. The failure of an owner to receive the notice as provided herein shall not affect the validity of an approved Tier II facility and shall not be the basis for an appeal. 12.The board of supervisors may consider an application for a Tier II facility only upon an appeal of the denial of the application by the commission. An appeal shall be submitted in writing in the office of the agent within ten(10)calendar days after the date of the denial by the commission. In considering an appeal,the board may affirm,reverse,or modify in whole or in part,the decision of the commission,and its decision shall be based upon the requirements delineated in this subsection(d). 13.Upon the written request of the applicant,the agent may authorize the height of an existing Tier II facility's monopole to be increased above its originally approved height upon finding that the reference tree has grown to a height that is relative to the requested increase in height of the monopole.The application shall include a certified survey of the reference tree's new height, as well as the heights of other trees to be considered by the agent.The agent shall not grant such a request if the increase in height would cause the facility to be skylighted or would increase the extent to which it is skylighted. This form created 2/15/12 Page 6 of 9 e. Tier III facilities. Each Tier III facility may''e established upon approval of a special use permit issued pursuant to section 31.2.4 of this chapter, initiated upon an application sa; ng the requirements of subsection 5.1.40(a)a action 31.2.4,and it shall be installed and operated in compliance with all applicabI"e"prrovisions of this chapter and the following: '4'# 1.The facility shall comply with subsection 5.1.40(b),subsection 5.1.40(c)(2)through(9),and subsection 5.1.40(d)(2),(3),(6) and(7),unless modified by the board of supervisors during special use permit review. 2.The facility shall comply with all conditions of approval of the special use permit. (§ 5.1.40,Ord.01-18(9), 10-17-01;Ord.04-18(2), 10-13-04) Waiver Criteria If an applicant proposes to submit less information than required or request a modification or waiver of any design criteria the request for modification or waiver must be received at the time the application is filed or the application shall be deemed incomplete. In requesting a modification or waiver the applicant shall provide information to allow the Board of Supervisors to find: 1. That complying with the provisions of the Zoning Ordinance would not forward the purposes of the Zoning Ordinance or otherwise serve the public health,safety,or welfare or; 2. That a modified regulation would satisfy the purposes of the Zoning Ordinance to at least an equivalent degree as the specified requirement. Definitions associated with Personal Wireless Service Facilities Antenna array:An orderly arrangement of antennas mounted at the same height on a tower or other structure and intended to transmit a signal providing coverage over a specific area for a single provider of personal wireless services.(Added 10-13-04) Avoidance area:An area having significant resources where the siting of personal wireless service facilities could result in adverse impacts as follows:(i)any ridge area where a personal wireless service facility would be skylighted;(ii)a parcel within an agricultural and forestal district;(iii)a parcel within a historic district;(iv)any location in which the proposed personal wireless service facility and three(3)or more existing or approved personal wireless service facilities would be within an area comprised of a circle centered anywhere on the ground having a radius of two hundred(200)feet;or(v)any location within two hundred(200)feet of any state scenic highway or by-way.(Added 10-13-04) Personal wireless service facility:A facility for the provision of personal wireless services,as defined by 47 U.S.C. § 332(Section 704 of the Telecommunications Act of 1996),including those Federal Communications Commission licensed commercial wireless telecommunications services such as cellular,personal communications services(PCS), specialized mobile radio(SMR), enhanced specialized mobile radio(ESMR),common carrier wireless exchange access services, unlicensed wireless services and,for the purposes of this chapter,unlicensed wireless broadband interne access. (Added 10-17-01;Amended 10-13-04;Amended 6-1-11) Reference tree: A tree designated for determining the top height of a treetop facility's monopole mounting structure.This may either be the tallest tree within twenty five(25)feet of the proposed monopole or a shorter tree that has been strategically identified for screening and camouflaging purposes. (Added 10-13-04) Ridge area:All land within one hundred(100)vertical feet of,and including,the ridgeline and peaks of a mountain or chain of mountains,as identified on a ridge area map approved by the board of supervisors. (Added 10-13-04) Ridgeline: The uppermost line created by connecting the peaks of a mountain or chain of mountains,and from which land declines in elevation on at least two(2)sides,as identified on a ridge area map approved by the board of supervisors.(Added 10-13-04) Skylight: Locating a personal wireless service facility in such a way that the sky is the backdrop of any portion of the facility. Skylight has the same meaning as"skylining,"as that term is used in the wireless policy.(Added 10-13-04) Tier 1 personal wireless service facility or Tier I facility: A personal wireless service facility that: (i)is located entirely within an existing building but which may include a self-contained shelter or cabinet not exceeding one hundred fifty(150)square feet that is not within the building or a whip antenna that satisfy the requirements of section 5.1.40(c);(ii)consists of one or more antennas, other than a microwave dish,attached to an existing conforming structure other than a flag pole,that do not exceed the height of the structure,and are flush mounted to the structure,together with associated personal wireless service equipment;or(iii)is located within or camouflaged by an addition to an existing structure determined by the agent to be in character with the structure and the surrounding district.(Added 10-13- 04) This form created 2/15/12 Page 7 of 9 Tier II personal wireless service facility or Tier II facility: A personal wireless service facility dim-is a treetop facility not located within an avoidance area.(Added 10-13-04) Nor "we Tier III personal wireless service facility or Tier III facility:A personal wireless service facility that is neither a Tier 1 nor a Tier II facility, including a facility that was not approved by the commission or the board of supervisors as a Tier II facility. (Added 10-13-04) Treetop facility: A personal wireless service facility consisting of a self-supporting monopole having a single shaft of wood,metal or concrete no more than ten(10)feet taller than the crown of the tallest tree within twenty-five(25)feet of the monopole,measured above sea level(ASL),and includes associated antennas,mounting structures,an equipment cabinet and other essential personal wireless service equipment.(Added 10-13-04) Owner/Applicant Must Read and Sign I hereby certify that I own the subject property, or have the legal power to act on behalf of the owner in filing this application. I also certify that the information provided on this application and accompanying information is complete,accurate,true, and correct to the best of my knowledge. I also certify that I have read and understand the regulations for Personal Wireless Service Facilities and that I understand the annual reporting obligations. I also understand the information that must be submitted for building permits and certificates of occupancy for Tier II and Tier III facilities. // January 31,2013 Sig ature of Owner, Contract Purchaser, or Applicant Date Stephen Waller,AICP 434-825-0617 Print Name Daytime phone number of Signatory This form created 2/15/12 Page 8 of 9 Required FEES to be patat time of application: What type of Personal Wireless Service Facility are you applying for? ❑ Tier I Facility $106.50 ❑ Tier II Facilities $1820 23 Tier III Facilities $2000 ❑ Notification Requirement for Tier II and Tier III for up to 50 notices $200 ❑ Notification Requirement for Tier II and Tier III for each notice over 50 notices* $1 plus the cost of postage ❑ Published notice cost for Tier III Facilities ** Cost is based on a cost quote from the publisher. ❑ Building Permit after Tier II or Tier III approval $106.50 *This fee is not collected at the time of initial submittal. This fee,if any,will be calculated by staff and the applicant will be notified of the fee amount and the deadline for payment. If the fee is not submitted by the deadline the applicant shall be deemed incomplete. **To be paid after staff review for public notice: Most applications for a Special Use Permit require at least one public hearing by the Planning Commission and one public hearing by the Board of Supervisors. Virginia State Code requires that notice for public hearings be made by publishing a legal advertisement in the newspaper and by mailing letters to adjacent property owners. Therefore,at least two fees for public notice are required before a Special Use Permit may be heard by the Board of Supervisors. The total fee for public notice will be provided to the applicant after the final cost is determined and must be paid before the application is heard by a public body. Staff estimates the total cost of legal advertisement and adjacent owner notification to be between$350 and$450 per hearing. This estimate reflects the average cost of public notice fees for Special Use Permit applications,but the cost of certain applications may be higher. Other FEES that may apply: ❑ Deferral of scheduled public hearing at applicant's request $180 Resubmittal fees for Tier III Facilities ❑ First resubmission FREE ❑ Each additional resubmission(TO BE PAID WHEN THE RESUBMISSION IS MADE TO INTAKE STAFF) $1,000 The full list of fees can be found in Section 35 of the Zoning Ordinance. This form created 2/15/12 Page 9 of 9