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CROWN 1505 Westlake Ave N, Ste 800
Phone: (503) 708-9200
Seattle,WA 98109 www.crowncasd 0e.com � 2027
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CASTLE LI-I.Y Or I-IGARD
BUILDING DIVISION
Project Data Sheet
Business Unit(BU) 879526
Application/Order Number 569682
Crown Castle Site Name TIGARD
Customer Site Number PT89
Site Address 8777 SW BURNHAM STREET
Site City,State,Zip TIGARD,OR 97223
Parcel Tax ID R2143974
Applicant/Agent New Cingular Wireless PCS, LLC by Crown Castle USA Inc.
Agent Address 1505 Westlake Ave N,Ste 800
Agent phone number (503)708-9200
Carrier AT&T Mobility
Add or replace antennas,ancillary equipment and ground equipment as per plans
Scope of work for an existing carrier on an existing wireless communication facility.
Property Owner CITY OF TIGARD
Property Owner Address 13125 SW HALL BLVD,TIGARD, OR 97223
Structure Type MONOPOLE
Structure Height 100 FT
Antenna Equipment Height 78
Size of Compound Sq. Ft. 0 sq ft
Latitude 45°25'42.07"
Longitude -122°46' 5.34"
Zoning Jurisdiction CITY OF TIGARD, OR
Zoning Jurisdiction Address 13125 SW HALL BLVD.,TIGARD, OR 97223
Permitting Jurisdiction CITY OF TIGARD, OR
Permitting Jurisdiction Address 13125 SW HALL BLVD.,TIGARD, OR 97223
The Foundation for a Wireless World
CrownCastle.com
CROWN 1505 Westlake Ave N,Ste 800
Phone: (503) 708-9200
Seattle,WA 98109 www.crowncastle.com
CASTLE
April 20,2022
CITY OF TIGARD,OR
Community Development
Debbie Adamski
13125 SW HALL BLVD.
TIGARD,OR 97223
Via Walk-in
**********NOTICE OF ELIGIBLE FACILITIES REQUEST**********
RE: Request for Minor Modification to Existing Wireless Facility—Section 6409
Site Address: 8777 SW BURNHAM STREET,TIGARD,OR 97223
Crown Site Number: 879526/Crown Site Name:TIGARD
Customer Site Number: PT89/Application Number:569682
Dear Debbie Adamski:
On behalf of New Cingular Wireless PCS, LLC("AT&T Mobility"or"Applicant"), Crown Castle USA Inc. ("Crown Castle")
is pleased to submit this request to modify the existing wireless facility noted above through the collocation,replacement
and/or removal of the Applicant's equipment as an eligible facilities request for a minor modification under Section 64091
and the rules of the Federal Communications Commission("FCC").2
Section 6409 mandates that state and local governments must approve any eligible facilities request for the modification
of an existing wireless tower or base station that does not substantially change the physical dimensions of such tower or
base station. Under Section 6409, to toll the review period, if the reviewing authority determines that the application is
incomplete, it must provide written notice to the applicant within 3o days, which clearly and specifically delineates all
missing documents or information reasonably related to whether the request meets the federal requirements.3
Additionally, if a state or local government, fails to issue any approvals required for this request within 6o days, these
approvals are deemed granted.The FCC has clarified that the 3o-day and 6o-day deadlines begins when an applicant: (1)
takes the first step required under state or local law; and(2)submits information sufficient to inform the jurisdiction that
this modification qualifies under the federal law4. Please note that with the submission of this letter and enclosed items,
the thirty and sixty-day review periods have started. Based on this filing, the deadline for written notice of incomplete
application is May 20,2022,and the deadline for issuance of approval is June 19,2022.
The proposed scope of work for this project includes:
1 Middle Class Tax Relief and Job Creation Act of 2012,Pub.L.No. 112-96,§6409(2012) (codified at 47 U.S.C.§1455).
2 Acceleration of Broadband Deployment by Improving Wireless Facility Siting Policies,29 FCC Rcd.12865 (2014) (codified at 47
CFR§1.6100);and Implementation of State&Local Governments'Obligation to Approve Certain Wireless Facility Modification
Requests Under Section 6409(a)of the Spectrum Act of 2012,WT Docket No.19-250(June 10,2020).
3 See 47 CFR§ 1.6100(c)(3). 4 See 2020 Upgrade Order at paragraph 16.
The Foundation for a Wireless World
CrownCastle.com
as% CROWN 1505 Westlake Ave N, Ste 800
Phone: (503) 708-9200
Seattle,WA 98109 www.crowncasUe.com
CROWN
E
Add or replace antennas, ancillary equipment and ground equipment as per plans for an existing carrier on an existing
wireless communication facility.
At the end of this letter is a checklist of the applicable substantial change criteria under Section 6409.Additionally,please
find enclosed the following information in support of this request:
(1) Collocation Supplemental Questionnaire;
(2) Building Permit Application;
(3) Construction Drawings;
(4) Structural Analysis;and
(5) Section 6409 Substantial Change Checklist.
As these documents indicate,(i)the modification involves the collocation,removal or replacement of transmission
equipment;and(ii)such modification will not substantially change the physical dimensions of such tower or base station.
As such,it is an"eligible facilities request"as defined in the FCC's rules to which the 6o-day deadline for approval applies.
Accordingly,Applicant requests all authorization necessary for this proposed minor modification under Section 6409.
In addition,this submission contains confidential,proprietary,or trade secret information that is exempt from disclosure
under applicable laws. Please make sure these pages are not disclosed. If any request is made for this information, please
contact the sender in addition to any legal notice requirements under applicable law.
Our goal is to work with you to obtain approvals earlier than the deadline. We will respond promptly to any request for
related information you may have in connection with this request. Please let us know how we can work with you to
expedite the approval process.We look forward to working with you on this important project,which will improve wireless
telecommunication services in your community using collocation on existing infrastructure. If you have any questions,
please do not hesitate to contact me.
Regards,
Zacf%Jhi &po
Zach Phillips
Site Acquisition Specialist
Crown Castle
Agent for Applicant
(503)708-9200
Zach.Phillips@crowncastle.com
The Foundation for a Wireless World
CrownCastle.com
('Nif'% po /L(N 1505
Westlake Ave N, Ste 800
CASTLE Phone: (503) 708-9200
Seattle,WA www.crowncastlecom
Section 6409 Substantial Change Checklist
Towers Outside of the Public Right of Way
The Federal Communications Commission has determined that a modification substantially changes the physical dimension of a wireless tower or
base station under 47 U.S.C.§ 1455(a)if it meets one of six enumerated criteria under 47 C.F.R.§ 1.6100.
Criteria for Towers Outside the Public Rights of Way
YES/NO Does the modification increase the height of the tower by more than the greater of:
NO (a) 10%
(b) or,the height of an additional antenna array plus separation of up to 20 feet from the top of
the nearest existing antenna?
YES/NO Does the modification add an appurtenance to the body of the tower that would protrude from the
NO edge of the tower more than 20 feet or more than the width of the tower structure at the level of the
appurtenance,whichever is greater?
YES/NO Does the modification involve the installation of more than the standard number of new equipment
NO cabinets for the technology involved or add more than four new equipment cabinets?
YES/NO Does the modification entail any excavation or deployment outside the current site by more than 30
NO feet in any direction,not including any access or utility easements?
YES/NO Does the modification defeat the concealment elements of the eligible support structure?
NO
YES/NO Does the modification violate conditions associated with the siting approval with the prior approval the
NO tower or base station other than as specified in 47 C.F.R.§ 1.6100(c)(7)(i)—(iv)?
If all questions in the above section are answered"NO,"then the modification does not constitute a substantial change to the existing
tower under 47 C.F.R.§i.6ioo.
The Foundation for a Wireless World
CrownCastle.com