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Home My WebLink AboutCorrespondence PLANNER 4/30/2008 , , Attachment 1. Resumes: C ~;ingfield . McKenzie fl!P004020J (.J ' HPNW r--~----- - - -~-- , David Plnyerd, Pnnclpal , Hlstonc Preservation Northwest : 111611lh Ave SW , Albany OR 97321 i 541-791-9199 (office) : 503-407-7489 (cell) plnyerd@hp-nw com I www hp-nw com I : EDUCATIONAL HISTORY u ~Io~ Date Received...:.!. ~ Planner. MEM " Sv-PW/ /0& f!-w'd;;J. . . ~7/d ~ f~(i7ob;'{p Mar 1993 - June 2000 Master of SCience University of Oregon, Eugene, OR , M S In Hlstonc Preservation, June 2000 ThesIs title, "The Preservation of Pre-World War II Coast Guard i Architecture In Oregon" - Sept 1981 - Aug 1985 Bachelor of SCience Oregon State UniverSity, Corvallis, OR B S In Business Administration with a concentration In Financial Services, Oregon State UniverSIty, August 11985 Minor In Computer SCience WORK HISTORY , , I Jan 2001 - present Hlstonc Preservation NW Oregon and Washington , I Established a group of consultants as Hlstonc Preservation Northwest We do everything from hlstonc bUilding survey to National Register Nominations Pnmanly we perform Section 106 documentation for new f cell towers and co-locates In Oregon and Washington for several prOViders , I i Apr 2002 - Jun 2007 Adjunct Professor University of Oregon , Teach the spnng term Hlstonc Survey and Inventory class at the University of Oregon as an adjunct professor , Nov 1994 - Dec 2000 Historic Preservallon Consultant Eugene, OR I Performed hlstonc bUilding surveys as an Independent consultant while I worked on my master's degree Also analyzed historic structures and ran preservation field schools ! (COMPLETE RESUME ON FILE AT THE OREGON STATE HISTORIC PRESERVATION OFFICE) I ------ ~----- -- --- - ------ - -- -- --- - -- April 21, 2008 Page 1 of 1 " Adaot Em!ineerilll!. Inc. . , " ... ......--r I~~/' Attachment 2. H' ), . Additional Site Information "f"' J T-Moblle has proposed tq mstall an 80-foot monopole adjacent to the bUlldmg located at this site The corre~pondmg eqUipment will be placed wltlun a 30 by 30 foot lease area at " the base of the pole~ . \ , , Attachment 3. Tribal and NHO Involvement Tnbal notlfical1on has been mil1ated through the Federal Commumcal1on Commission's Tower ConstructIOn NolificatlOn System Attachment 4. Local Government T -Mobile IS workmg directly with the City of Spnngfield to obtam necessary permits The status of zonmg and bUlldmg permits IS unknown to Adapt at thiS lime Attachment 5. Pubhc Involvement On Apnl 8, 2008 the followmg public nolice will appear m the local newspaper, The RegIster-Guard An 80-foot tall FCC lIcensed wireless telecommumcal1on tower IS to be located at 2095 Yolanda Ave, Sprmgfield, Lane County, Oregon The FCC IS seekmg public comment on the proposed project as part of the review process by the Oregon State Histone PreservatIOn Office Please respond wIthm 30 days of thiS pubhcalion to Adapt Engmeenng Inc. 10725 SW Barbur Blvd. SUite 350, Portland, OR 97219 Attn McKenzie Attachment 6. AdditIOnal Consultmg Parl1es The Spnngfield Histoncal Commission was nOlified of the proposed project on Apnl18, 2008 T Mobile - P004020J J McKenzie Adapt proiect No OR08-15258-NEPA April 23 2008 , ... ( \ 'Attachment 7. APE: Sprint~Jd. McKenzie ilP004020J '-..I HPNW The proposed project (Adapt #OR08-15258-NEPA) IS to Install a new 80-foot steel pole with three flush- I i mount antennas In Springfield, Oregon, as shown In Figures 1 through 3 The cellular equipment would be located In a 30'x30' fenced compound surrounding the monopole Direct effects would be limited to the monopole foundation, equipment pad, and trenching to utilities , A check of the National Register for listed resources In the area was performed on Apn118, 2008, and no , resources were found within the half-mile vlclmty The Oregon SHPO requests a limited reconnaissance survey of the area to locate resources eligible for I the National Register In lieu of a site file check at the SHPO office A limited reconnaissance survey was I therefore carried out by David Plnyerd, with the assistance of Bernadette Niederer, on Apn118, 2008 The , Area of Potential Effect (APE) to assess visual effects of t~e proposed monopole on hlstonc resources was i defined as a 0 5 mile radiUS circle (Figure 2) We drove the APE to seek out any historic resources : eligible for the National Register and the extent of the monopole's vIsibility Sample views were I photographed towards the proposed monopole from throughout the APE and the photo locations are plotted on Figure 4 The monopole IS simulated In each photo (when it can be seen) with a red tnangle I , pOinting towards ItS top The APE was then constricted as the monopole would not be visible due to trees I and buildings throughout some of the standard APE (Figure 5) The proposed installation IS behind the Emerald Square Dance Center In north Springfield The bUilding IS 'part a small shopping center bUilt c 1963 The area was bUilt up In the first half of 1960s on filbert I orchards A small remnant orchard lies to the northwest of the proposed site at Yolanda Avenue and 20th Street Nearby to the east and northeast are the Briggs Middle School (1963) and Yolanda Elementary School (1963), respectively The area IS relatively flat The McKenzie River lies to the north Just outside the APE April 21, 2008 Page 1 of 1 Attachment 8. Visual Effects: (....,)ingfield - McKenzie IIIP004020J ~ __I HPNW Map number 0 Name NO RESOURCES ELIGIBLE FOR THE NATIONAL REGISTER WERE FOUND Street City State ZIP Spnngfield OR 97477 NR findings ~~-~~------ -~--- - - ~- - ~--- ----- ------ -- --_. ,April 21, 2008 Page 1 of 1 Attachment 9. Direct Effed._ "Springfield - McKenzie iP004020J \,...) HPNW NO NATIONAL REGISTER LISTED RESOURCES AND/OR NATIONAL REGISTER-ELIGIBLE RESOURCES WOULD BE DIRECTLY AFFECTED BY THIS PROJECT April 21, 20011 Page 1 of 1 Attachment 10. Effects: SprinL_ .td . McKenzie IIPOO.<\020J ~_) HPNW Map number 0 Name NO RESOURCES ELIGIBLE FOR THE NATIONAL REGISTER WERE FOUND Street City State ZIP Spnngfield OR 97477 NR findings Effect findings Effect April 21, 20011 Page 1 of 1 Attachment 11a. Photogra'. :': Springfield - McKenzie il'P004020J ,,---,). HPNW View Approx d'stance Direction From installation NA north Photographer Date recorded Focal length Bernadette Niederer 4/16/2006 7mm View From Installation Approx distance NA Direction east ~ Photographer Date recorded Focal length Bernadette NIederer 4/16/2006 7mm April 21, 2001 Page 1 of 7 Attachment 11a. PhotographL,-,Springfield. McKenzie NP004020J \ _.i HPNW ' View Approx distance Direction From installation NA south Photographer Date recorded Focal length Bernadette Niederer 4/1812008 7mm r T~,--~ ~'- ~ I~ _.l~']2i ~~\ f t~ ,_"i~~"""~ ~ '-: ? '" ~:f' fc.~JI' if"1~,r' View Approx distance Direction From Installatton NA west Photographer Date recorded Focal length Bernadette NIederer 4/18/2008 7mm April 21, 2008 Page 2 of 7 Attachment 11.. PhotogrJ. ;: Springfield. McKenzie IIP004020J () HPNW !...,,*~ I, I ',' , " " r < _ ~ ~~;"'" ~~ ;,::t "-'iT'" ~, 1 'I' ~ , \' w ~ " .1 ,. View Approx distance DIrection 1 (towards proposed installation) 158 ft east Photographer Date recorded Focallenglh Bernadette Niederer 4/1812008 7mm ; ~------- III View Approx distance DIrection 2 ( lowards proposed ,"slallallon) 317 ft south Phologrepher Date recorded Focal length Bernadette Niederer 4/1812008 7mm April 21, 2008 Page 3 of 7 Attachment 11a. Photographt__~:'prin9field - McKenzie HP004020J ',.J HPNW View Approx distance Direction 3 ( towards proposed Installabon) 370 ft west Photographer Date recorded Focal length Bemedette Niederer 4/16/2006 7mm View Approx distance Direction 4 ( towards proposed ,"slallabon) 264ft north Photographer Date recorded Focal length Bernadette Niederer 4/1612006 7mm April 21, 20011 Page 4 of 7 Attachment 11a. Photogr~.. _ J: Springfield. McKenzie NP004020J () HPNW r -, View Approx distance DirectIOn 5 ( towards proposed installation) 581 ft northeast Photographer Date recorded Focal length Bernadette Niederer 4/1812008 7mm I ~ ~ View Approx distance Direction 6 ( towards proposed installation) 739 ft northwest Photographer Date recorded Focal length Bernadette Niederer 4/18/2008 7mm April 21, 2008 . Page 5 of 7 Attachment 11a. Photographt~"Springfield - McKenzie IiIP004020J ~ __\ HPNW View Approx distance Direction 7 ( towards proposed Installation) 845 It southwest Photographer Date recorded Focallenglh Bernadette Niederer 411812008 7mm \ '. ."~'" k.' $" \.'>"':' ~..1F' . '-r:U , ."'~' ~ ~^'1i \ -1i4 ,....,\t~ , '. '. '.. ..~~~ ',"Ii" , VIew Approx distance DIrection 8 ( towards proposed InstallallOn) 792ft south Pholographer Date recorded Focal length Bernadette NIederer 411812008 7mm April 21, 200ll . Page 6 of 7 Attachment 11a. PhotOgr;(): Springfield - McKenzie IIP004020J '.) HPNW View Apprax distance DIrectIon 9 ( towards proposed installation) 898 n southeast Photographer Date recorded Focallenglh Bernadette NIederer 4/18/2008 7mm April 21, 20011 Page 7 of 7 . . Attachment 12. Maps: Spring.".J, McKenzie It!P004020J " _~ HPNW 123002'00" W 123000'00" W z '0 o 1--.' o o o V v =-:1 z o .' 0 a-(Y') vi 0 o ~ z April 21, 2008 Page 1 of 5 'Attachment 12. Maps: Spri, ield - McKenzie ;tIP004020J ' ) HPNW ~ .J 123000'00" W WGS84 122059'00" W , , ~J---=~: 1'~~~ (\\~~~t:;-~~:-:r(0))))JW( I f''' '-::._ ')) ) i '; ': ' \ ~\' '"',"j ~~~,::=::::;#!)!IJJ/' /} ) l{Gq, /,. / ,I)' I, I ,~\ '\?@~ ---1-~- rfi;'-"'tVl':: ~/II i, ,) \ '-- ) I II 76 '~~.~~~\~,\.. irciJjh../'- J// 1'/'}'\\---""/83' I ,~) , 'N\.~~-i}.'''''''''~1'~\ I. '10 \, ,---. /. 'Ii ~ Y ~"~, '''....-......... --;. _....7/1'.............- 1') _ \. "JI. . "/ z , I tot,,", '} \' ~?-:~r=:-;.~~{ r .1 I~ ,!,\ ----~- ~'"'/~~lJI 7" '. ;" \'~::..:..:'~:;:.-'~X:~~......r~/~ 18 1 '.1 . IA - - \, :-::-:.:-:'::'''-:::-':.;;1 ~~. ~\\ 'N' .')0./-" /, \~ 'In : ", ' ~~=~~ -~::::----. v~ --- -""--. -'(fj' 1\1 0 .. '. :~. \.t_>-~~;-";-" ,.~ _ 0; , " ~ '--,. ~ I '..-..' - ..- - .II'<=.> -"'.~ I . l v~~r~....- .r!JI1 I I ,~,~ '/-:'"/:::J.~r--~~J.3i.,l,^~ " } . Mile 12_ . ;.- __-' c.....:- _ . ',' I -, -- ~-:-j.-. ------.+- '=-::<=f'~- .....,'-- J ~-~, . I ",..,-, _.....-------~-~ ~r.. ~ II .,,1 ,.;.... ../. - .- ~.. ~ >) n .... I /'... ..-lo' II ./ ,/~ / _....-; :::.; - ,. I . '... u I '/.- ~"<O4 -("" ~..' skI "'" /_::."...w (I ~~.;,l l ~1r: f 1:1~:.::~11l . ;' .~ . ;.. i: PS Q' ) "~Q:I l:l "=_ :~.:. rj.,.(' I ~.. " ~I. --.j" -~ )~. ~ "II ' ~r- 1"_~':"'l,::N, II l, I' ,~ ..J \: r -, YOI~. .' -, ~... \ . . .'" . Jl '$1:11 (I ,: t<,1 II Seht, I ~,Y) ~_ ~.. 11'[ . 1_"";,, '-.;;p; , . fi ~ ""t;-., I..... -.. 'I - ( . ~.. . ,,. "'" .J" ~~((_ ~.~~ ~ " ,,' ,.-<1" _-". 111 irj-- ."' '56 ~~-- Brllll<a'-\i''':- " '!I~" - ~,~, ~'h I ].~' ., = Jr HS 0" .. I 0 . ,_ . ,,- (' '~jJ I ~- t 't~ ~-" 1'1 I,,,,,~_=~~::...:;~""'~ 4-- ~IOGd 1.5)!' J ~JPO! Ir.r(C4S~-;~., ,,'-:.. fl"-" ~jr\'1~' '-COIl"F"~ ::.-np.~ = - . ,_..--,,~,- , I~-'~i;~_. z "1" ..r.~"--'~f~i . i"'- -''(i~Stff.i: ~ 8 ~ J I ~f t; ~_-~~r>II-='ll -s: ~:.. ~J ~ l'-~):: \ ~,--~-~\~ g ~. 1,.f;,x'jl-T1Ill I) [I" -', . '-.., \ ;r'~'-'--l -- -,.- : - -.' l'-r'11-'0-)1 --'.~ " I I L ? ~,~ ~ 1 ..J ~. (;, l' '" o II i" "- i ~ -==-=.""""" . 0 o t.,t:::~__.._ ,,"":,.. "r-+ 0 ~ ~' s ~-~"-'-~JL;;~I .,....-:.!- _. M ~i'\1 ,yJ.............-: ~ i ~ '5}~ '5" (, f-~~-"'-':;'''''' 1::-" 5~.1":-'1~~'"""1' I-=-"'~-~' .." II ' 1- ~ 1;1 S!W!J: "I .:,-,..~: 1:-;:,t'.;:~_.~@L-L.:-~ -' \- -~',.:" _~~i900 4 w'r_.ll~-~ _ ':;~O' f :r:-Ii-.tl!J:.= Jl[ '\~ i~. i- -..1, ~~.81 II' !:99 :. . .~ .~l "'!,J,1::'~~f""~' on-'o.==-= i i ~; md J~ I ""'-... , It-. Oi':lM[~:~I-=!"I,."lrr..'nr.l ( I __'_ _=:n_~___~, -- ,.l~,,-il..' NO.n. I. \ ~. ,-~.-. -R' ., 1~1' (I--~' ~'-11 ;J!<"f" .;;: t--(::l---:r~;----_._--t! ~C.I: II --~--~--~}r',~ ~11~.:f:~~.:I: \1: =-=lr-lr.-ll'l"-~~'-_., ..~.' 69 SPRINGFIELD '6Q:\ 0 .;l' '!Il' ,,\1 1 lit; I j. ~. · c..-rlr== =~~- ~i~ '~ . .:.: r-' i ~; I .]' - '1~=JG;~"--'1Ijt ~ .' .-.].. ;_.~_..t?~G.~;~!tl (h~ll~..::;!W:~i:C1 I ~:; - 2R. --, 2'". ~t;71' :=: ~I _......~F"';J 'L' .. - ~.._- ~:' ~\=;i'..Ir! l' I P --~_I~=I-' .:;l-'=~CJ'. J ~ sr '1\ <.,...:..."~,,-,, ..- '1=-=-F.-" ~t~~' -'~---'r, -.Tl~ 'A '\,?> "1--."=" .I r-- ":)-6"";: 0 .L II I'" . . 0, _ -.. !:_ ~ ~~=' ", ..,C L____.J. _.~ _"- . " .~. ,. _-'~~ . ,-, 123000'00" W WGS84 122059'00" W TN"!MN ~ 5 I MilE /17' ll= _ _1000 fEET 0 !JOO J<XXl METEns Figure 02 Springfield, OR 7 5 minute quad map (1986/1986) shOWing the standard 0 50 mile APE for the proposed monopole installation in Spnngfleld - '" - - ~.. z (:) o In' o o "" "" '-~ ~~ , April 21, 20011 Page 2 of 5 Attachment 12. Maps: Spring.._ ,d - McKenzie IIP004020J __ ~ HPNW " Figure 03 USGS aerial from 2000 showing the Immediate area around the proposed monopole installation In Spmlgfleld April 21, 2008 Page 3 of 5 ( ~ . ' Attachment 12, Maps: Spr,_ )ield - McKenzie tlP004020J '--.) HPNW NCRTH liNGFIELD I II rese ve ... " ~ ~ '. -" ~ ':)"- ~. Z "- I! 0 , ~ .. VI '. ,!a ~ :> q; : '0 ~ II C;: " (!! . \.:> I, YOIMdil Ave 9'1 . ., z Z 0.. Yenta ... ~ AYe - VI I.... ~ ~ - r.... ~ JI !n Bridge Rd Ave II OttO S\ " n;\{1)bHng Dr II If J I Hayden Bridge Rd 1 i .t ::I.... IV " ~<I'l -, ,]!fJ I'.::i' :T Il J VI ~ " Ii , N ... .... .... .z- .... -- VI -e M N I I ~ Yolanda II D IS' Elementary~ Z llap HIe f' ;::,- . I 7 NVI .; - II 2 Yolanda Ave Briggs . 3',,- 1 ePOL"'O Middle ~ School ~ ?'3(\(.t\ 8 (orr3\ or pJe{(e . POlk " \ IV ';l ':s' VI TI " 0\\0 ~\6 - VI ~ - (,"\ - II \.ot\'lOr :1 II LOmOnd \, N Ave ... ~ <Il " Hrlh Ave "0 ~ - '" Figure 04 Current street map shOWing the APE area for the proposed monopole Installation In Springfield with labels corresponding to sample views April 21, 2008 Page 4 of 5 Attachment 12. Maps: Spring\~_J - McKenzie IiP004020J ~,' HPNW r II rCse_ ve , ... ~ ?t, 't 'Z- II If II II "- II Q IV - ~ - - V) Vl II' ~ !O .c 'i" :> Qi 1:1\___ :::l "0 ... " C: ~ (!! \-' , Yolanda Ave 91 , J I Hayden Bridge Rd r .1 ' :) .... IV ~Vl !?1 ...J II II ~ TI NCRTH ~:NGFHD ... " " z Z Q. Yenta - .c Ave - Vl ,.... .c ~ - ,.... ~ " II OttO S\ Yolanda If ementary'5 Z ,,'..... NVl II olanda Ave Briggs Middle School , . ) P/eICe POlk " I 'n Bridge Rd If - \I'l .c - "'... ~ II Lomond IIv(' " IV - ~ VI ~ Hrth Ave ~ Ii \.otO 01 II 'we nilmbllng Or Figure 05 Current street map shOWing the modifIed APE In pink for the proposed monopole Installation In Springfield with labels corresponding to sample views April 21, 2008 Page 5 of 5 Approved by OMS 3060-1039 Estimate Time Per Response 5 to 10 hours Federal Communications Commission Washington, DC 20554 New Tower ("NT") Submission Packet FCC FORM 620 Introduction The NT Submission Packet IS to be completed by or on behalf of Applicants to construct new antenna support structures by or for the use of licensees of the Federal Communlcalions COmmission ("FCC") The Packet (Including Form 620 and attachments) IS to be submitted to the State Hlstonc Preservatton Office ("SHPO") or to the Tribal Hlstonc Preservation Office (UTHPO"), as appropnate, before any construction or other installation acttvlttes on the site begin Failure to prOVide the Submission Packet and complete the review process under Section 106 of the Nattonal Hlstonc Preservatton Act (UNHPA")' pnor to beginning construction may Violate Section 11 O(k) of the NHPA and the Commission's rules The mstruclions below should be read m conJunclion With, and not as a substitute for, the "Nalionwlde Programmatic Agreement for Review of Effects on Hlstonc Properties for Certain Undertakmgs Approved by the Federal Communlcallons Commission," dated , 2004, ("Nallonwlde Agreement") and the relevant rules of the FCC (47 C F R 99 1 1301-1 1319) and the AdvIsory Council on Hlstonc Preservalion ("ACHP") (36 C F R Part 800) 2 ExclUSions and ScoDe of Use The NT SubmiSSion Packet should not be submitted for undertakings that are excluded from Section 106 Review The categones of new tower construclion that , 16 U S C S 470f \ 2 Section II A 9 of Ihe Nationwide Agreement defines a "histOriC property" as "Any prehistOriC or hlstonc distriCt, Site, bUilding, structure, or object Included In, or eligible for inclusion In, the National, Register maintained by the Secretary of the Intenor ThiS term Includes artifacts, records, and remains that are related to and located Within such properties The term Includes properties of tradlllonal religiOUS and cultural Importance to an Indian tribe or Native HawaIIan Organization that meet the National Register criteria " Applicant's Name I-mobile Project Name O't" ~ fW1?,.1 Project Number f D <t<-l1i5 2 <15:\ FCC Form 620 December 2007 NT SUBMISSION PACKET - FCC FORM 620 Approved by OMS 3060-1 039 Estimate Time Per Response 5to 10 hours are excluded from historic preservation review under Section 106 of the NHPA are described In Section III of the Nationwide Agreement Where an undertaking IS to be completed but no submission will be made to a SHPO or THPO due to the applicability of one or more exclusions, the Applicant should retain In ItS files documentation of the baSIS for each exclusion should a question arise as to the Applicant's compliance with Section 106 The NT SubmiSSion Packet IS to be used only for the construction of new antenna support structures Antenna collocations that are subJect to Section 106 review should be submitted uSing the Collocation ("CO") SubmiSSion Packet (FCC Form 621) Generallnstructions NT SubmiSSion Packet Fill out the answers to Questions 1-5 on Form 620 and provide the requested attachments Attachments should be numbered and proVided In the order described below For ease of processing, proVide the Applicant's Name, Applicant's Project Name, and Applicant's Project Number In the lower right hand corner of each page of Form 620 and attachments 3 1 Applicant Information Full Legal Name of Applicant I-W\Dlode. FCC Registration Number (FRN) 00 \ IPqq I &'-1 '0 Name and Title of Contact Person ~f2p \;10 PI/" 'v>,lJ:. t~t EtfYleP vi ~ '% T-Yl1L/odc Address of Contact Person (Including Zip Code) \Dll<::; .<:W ~bu.r AlurA Stc 'J.j.;o. Pcd-(av.a Ore- 172Jq Phone "Jll-:l,' '2,'1~- J",t./(n Fax <;0'0 - 9Ft J. - '+3'[2. E-mail address IoeH,. 101'-\ <Jl'Ijer @ (~eVl8'-' Cel""'_ 3 Some attachments may contain photos or maps on which this Information can not be proVided Applicant's Name 1 ... ltVI,.,i.." Ie Project Name ,,^,~ ~_V1?:. p, Project Number f() /l>'-fa> L ",-:r FCC Form 620 December 2007 NT SUBMISSION PACKET - FCC FORM 620 Approved by OMS 3060-1039 Estimate Time Per Response 5 to 10 hours 2 Applicant's Consultant Information Full Legal Name of Applicant's Section 106 Consulling Firm ffL"n,v, '- Pr,,"~eyu<1l1b.1 ^ 10v-H,wesr Name of Pnnclpallnvesligator htWld Al/'UDVo! J Title of Prlnclpallnvesligator HI SftVI (.. Pre <,po/.)edloVl Yi'lljr.rl- Invesligator's Address 1111 u 11~..b -RvP. <IN City A\\0"v1(j "'i':lJ - /q 1- q /C/1 State 'OR Zip Code 972,71 Phone Fax "')41- t.J8"'i - '-//..,:l,-J- E-mail Address e;Vlj""',t ~ hp - nw .('--0W\ Does the Pnnclpal Investl~l~ salisfy the Secretary of the Intenor's Professional Quallficalion Standards?' 'C:V NO Areas In which the Pnnclpal Investigator meets the Secretary of the Intenor's Professional Qualification Standards /i."'--CY,,'i:J:..c.tJLv-,d -HI", 11>7 U Other "Secretary of the Intenor qualified" staff who worked on the Submission Packet (provide name(s) as well as well as the area(s) In which they are qualified) , The Professional Qualification Standards are available on the cultural resources web page of the Nallonal Park Service, Department of the Intenor <httpllwwwcrnps govflocal-law/arch_stnds_9 him> The Nationwide Agreement requires use of Secretary-qualified professionals for Identification and evaluation of hlstonc properties Wllhln the APE for direct effects, and for assessment of effects The Nationwide Agreement encourages, but does not require, use of Secretary-qualified profeSSionals to Idenllfy hlstonc properties Within the APE for indirect effects See Nallonwlde Agreement, !l!j VI D 1 d, VI D 1 e, VI D 2 b, VI E 5 Applicant's Name 1- VV\c6i Ip Project Name fl.i': )6)V1"Z,.. Project Number I'D (/).., 16 2 Ib , FCC Form 620 December 2007 NT SUBMISSION PACKET - FCC FORM 620 Approved by OMB 3060-1039 Estimate Time Per Response 5 to 10 hours 3 Site Information a Street Address of Site 2 o~ ') Yo l ~ t\., AI! e , City or Township ~Y;0-hell County / Pansh J.....fUI\e State 1)'1(. Zip Code CJ; 't,-7 b Nearest Cross Roads .;;z \;tt- S+ I"ee t / (pv-vaJ Dr", vc c. NAD 83 Latitude/Longitude coordinates (to tenth of a second) N .:\:L 0 D~' ~~", w I J;J 0 .2i.' .2L'1." d Proposed tower height above ground level 5 160 feet. meters e Tower type o guyed lattice tower 0 self-supporling latlice ~ monopole o other (bnefly descnbe tower) 4 Project Status · a ~onstructlon not yet commenced, b [] Construction commenced on [date] c [] Construction commenced on [date] completed on [date] I Of, and was 5 Include top-mounted attachments such as lightning rods · Failure to proVide the SubmiSSion Packet and complete the review process under Secilon 106 of the NHPA prior to beginning construction may Violate Section 110(k) of the NHPA and the Commission's rules See Secilon X of the Nationwide Agreement Applicant's Name Project Name Project Number T-l'YIeh,(e. rnc.. ~eVl7=lo"_ Po M<.J 12l.2. 11/., 1 FCC Form 620 December 2007 NT SUBMISSION PACKET - FCC FORM 620 Approved by OMS 3060-1 039 Estimate Time Per Response 5 to 10 hours 5 Applicant's Determination of Effect a Direct Effects (check one) IP<L II [] 111 [] IV [] No Hlstonc Properties In Area of Potential Effects ("APE") for direct effects, "No effect" on Hlstonc Properties In APE for direct effects, "No adverse effect" on Hlstonc Properties In APE for direct effects, "Adverse effect" on one or more Hlstonc Properties In APE for direct effects b Visual Effects (check one) 1<)<1) II [] 111 [] IV [] No Histone Properties In Area of Potential Effects ("APE") for Visual effects, "No effect" on Hlstonc Properties In APE for Visual effects, "No adverse effect" on Histone Properties In APE for Visual effects, "Adverse effect" on one or more Hlstonc Properties In APE for Visual effects Certification and Slonature I certify that all representations on thiS FCC Form 620 and the accompanYing attachmen~s 1e true, correct, and complete Mkt5J:LJI/l(J,A y 4- ;):~-()R Slgnature<::f Date &il^ &Id~ev Pnnted Nah:le ffliJl'~DYI~"-h.J G.v..sJl-axi TItle WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATIACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.s Code, Tille 18, Section 1001) AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U S Code, Title 47, SectIOn 312(a)(l) ANDI OR FORFEITURE (U S Code, TlUe 47. Secllon 503) Applicant's Name Project Name Project Number l' -11/1 ()101 Ie. VV1C.~Vl~IP fie 0'1 II ) <;b:r FCC Form 620 December 2007