Administrative Manual January 2025

Part 4. Appendices 4.5 Checklists

4.5.31 Telecommunications Facility Collocation/Modification Telecommunications Facility Collocation/Modification Submittal Checklist For each listed item, check (√) if provided, write “n/a” if the feature does not exist or is not proposed, and write “w” if a waiver from the requirement is justified because it is unnecessary in the particular case to determine compliance with applicable regulations. Staff Use Only √, n/a, or w Application Submittal Requirement √, n/a, or w A Documents to be Submitted 1 Fee payment 2 A detailed written explanation (submitted electronically) of the circumstances necessitating the change 3 11"x 17" prepared and sealed by a qualified design professional B Complete Site Plans of the proposed changes 1 Existing conditions displayed in the background of the site plan in grayscale 2 Proposed changes must be shown in bold and all corresponding elements must be labeled 3 Strike-through items being removed or changed 4 If needed, the site plan must include a reference to relevant construction detail(s) 5 Additional construction detail(s) must be provided on the site plan or a separate sheet 6 Title block • Site plan name and submittal date

• Tower number and address • Town project and file numbers

7 8 C

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Graphic and numeric scale

Other

1 A statement on letterhead from a qualified individual that the applicant will comply with all FCC rules regarding human exposure to radio frequency (RF) energy, along with the individual’s qualifications 2 A statement on letterhead from a qualified individual that the applicant will comply with all FCC rules regarding RF interference 3 A structural certification by a Registered Professional Engineer that the facility complies and will continue to comply with EIA/TIA-222-G (as amended) for Wake County, NC 4 Supplemental information may be requested for purposes of clarify or confirmation

4.5.32 Telecommunications Facility New Tower New Telecommunication Facility Construction Plan Approval for a Site Plan (Major or Minor) Submittal Checklist For each listed item, check (√) if provided, write “n/a” if the feature does not exist or is not proposed, and write “w” if a waiver from the requirement is justified because it is unnecessary in the particular case to determine compliance with applicable regulations. Staff Use Only √, n/a, or w Application Submittal Requirement √, n/a, or w A Documents to be Submitted 1 Sets of plans – 24"x36"

2 Elevation and bench-marks referenced to National Geodetic Vertical Datum (NGVD) 3 Compact disc of plans with a PDF of each submitted plan sheet and all reports/documents

Morrisville, NC

May 29, 2020

Administrative Manual

Page 66