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ApplicationApplicant name:GARY ABRAHAMS, GMA NETWORK SERVICES Phone: Applicant address:P.O. BOX 2006, BELLEVUE, WA 98009 Email:gary@gmanetworkservices.com Owner name:CROWN CASTLE, CROWN CASTLE Phone:Fax: Owner address: 1505 WESTLAKE AVENUE NORTH, UNIT 800, SEATTLE, WA 98109 Email:chris.listfjeld@crowncastle.com Administrative Applicant Information Type of Review Requested File number:A-2021-0125 Assigned Planner:Cameron Scott Related Files: Subject Property Information Location/street address:1250 W USTICK RD Assessor's parcel number(s):R9532190560 Township, range, section:4N1W36 Agent name (e.g. architect, engineer, developer, representative):GARY ABRAHAMS Firm name:GMA NETWORK SERVICES Phone:Fax: Address:P.O. BOX 2006 Email:gary@gmanetworkservices.com Contact name:Phone:Fax: Contact address:Email: Project Description Planning Division ADMINISTRATIVE APPLICATION 33 E Broadway Avenue, Suite 102ƔMeridian, Idaho 83642 Phone: (208)884-5533ƔFacsimile: (208) 888-6854ƔWebsite: www.meridaincity.org 1 Project/Application Name:Dish Wireless - CZC Description of Work: Dish Wireless proposes to modify this existing site as follows: Proposed Tower Scope of Work: ‡Remove Abandoned Mount and Equipment at 146¶ ‡Install (3) Proposed Panel Antennas (1 Per Sector) ‡Install (1) Proposed Platform Mount ‡Install (6) Proposed RRUs (2 Per Sector) ‡Install (1) Proposed Over Voltage Protection Device (OVP) ‡Install (1) Proposed Hybrid Cable ‡Install Proposed Jumpers Proposed Ground Scope of Work: ‡Install (1) Proposed Equipment Pad ‡Install (1) Proposed Ice Bridge ‡Install (1) Proposed PPC Cabinet ‡Install (1) Proposed Equipment Cabinet ‡Install (1) Proposed Power Conduit ‡Install (1) Proposed Telco Conduit ‡Install (1) Proposed Telco-Fiber Box ‡Install (1) Proposed GPS Unit ‡Install (1) Proposed Safety Switch ‡Install (1) Proposed Fiber NID (If required) ‡Install (1) Proposed 200A Meter 33 E Broadway Avenue, Suite 102ƔMeridian, Idaho 83642 Phone: (208)884-5533ƔFacsimile: (208) 888-6854ƔWebsite: www.meridaincity.org 2 APPLICATION TYPES Alternative Compliance - ALT:UNCHECKED Certificate of Zoning Compliance - CZC:CHECKED Does project have prior approval?:Yes Does your project contain new construction and/or modifications to an existing building or the site?: No Design Review - DES:CHECKED Private Street - PS:UNCHECKED Vacation - VAC:UNCHECKED ADDRESS VERIFICATION Address Verification Permit Number:LDAV-2021-0462 TYPE OF USE PROPOSED Residential:UNCHECKED Office:UNCHECKED Commercial:UNCHECKED Employment:UNCHECKED Industrial:UNCHECKED Single-Family Detached:UNCHECKED Single-Family Attached:UNCHECKED Townhouse:UNCHECKED Duplex:UNCHECKED Multi-Family:UNCHECKED Vertically Integrated:UNCHECKED Other Type of Use Proposed:Wireless Facility/monopole PUBLIC WORKS INFRASTRUCTURE Does this project require the extension of public infrastructure?:No I agree to upload required checklist items for review:UNCHECKED I acknowledge deferral of the required checklist items, may require additional review time: UNCHECKED I agree to upload required checklist items with the building application:UNCHECKED PROPERTY INFORMATION General Location:W. Ustick Road Current Land Use:Residential Total Acreage:1.67 acres Prior Approvals (File Numbers):A-2016-0308; A-2018-0213; A-2020-0209 ZONING DISTRICT(S) R-2:UNCHECKED R-4:UNCHECKED R-8:CHECKED Application Information 33 E Broadway Avenue, Suite 102ƔMeridian, Idaho 83642 Phone: (208)884-5533ƔFacsimile: (208) 888-6854ƔWebsite: www.meridaincity.org 3 R-15:UNCHECKED R-40:UNCHECKED C-N:UNCHECKED C-C:UNCHECKED C-G:UNCHECKED L-O:UNCHECKED M-E:UNCHECKED H-E:UNCHECKED I-L:UNCHECKED I-H:UNCHECKED O-T:UNCHECKED TN-C:UNCHECKED TN-R:UNCHECKED County:UNCHECKED PROJECT INFORMATION Site Plan Date (MM/DD/YYYY):05/21/2021 Elevations Date (MM/DD/YYYY):05/21/2021 In Reclaimed Water Buffer:No QUALIFYING OPEN SPACE Open Grassy Area (min. 50' x 100'):UNCHECKED Community Garden:UNCHECKED Ponds or Water Features:UNCHECKED Plaza:UNCHECKED Additions to Public Park:UNCHECKED Collector Street Buffer:UNCHECKED Arterial Street Buffer:UNCHECKED 8' or 6' Wide Parkways:UNCHECKED 10' Parkway Along Arterials:UNCHECKED Stormwater Detention Facility:UNCHECKED QUALIFYING SITE AMENITIES Clubhouse:UNCHECKED Fitness Facilities:UNCHECKED Enclosed Bike Storage:UNCHECKED Public Art:UNCHECKED Picnic Area:UNCHECKED Additional 5% Open Space:UNCHECKED Communication Infrastructure:UNCHECKED Dog Owner Facilities:UNCHECKED Neighborhood Business Center:UNCHECKED Swimming Pool:UNCHECKED 33 E Broadway Avenue, Suite 102ƔMeridian, Idaho 83642 Phone: (208)884-5533ƔFacsimile: (208) 888-6854ƔWebsite: www.meridaincity.org 4 Children's Play Structure:UNCHECKED Sports Courts:UNCHECKED Pedestrian or Bicycle Circulation System:UNCHECKED Transit Stop:UNCHECKED Park and Ride Lot:UNCHECKED Walking Trails:UNCHECKED APPLICATION DISCLAIMER I have read and accept the above terms:CHECKED Your signature:Gary Abrahams 33 E Broadway Avenue, Suite 102ƔMeridian, Idaho 83642 Phone: (208)884-5533ƔFacsimile: (208) 888-6854ƔWebsite: www.meridaincity.org 5