Fill - Free fillable APPLICATION FOR SPECIAL PERMIT AND SITE PLAN APPROVAL (City of Lawrence Massachusetts) PDF form

APPLICATION FOR SPECIAL PERMIT AND SITE PLAN APPROVAL

(SPSA)

Notice: Application must be typewritten, completed in full and accompanied with 11 copies of

completed application packages as noted in the attached checklist. One copy must be filed

with the City Clerk prior to filing with the Planning Board. All copies must be date stamped by

the City Clerk. The package should be accompanied by all information provided for in Sec. 29-

24 through 29-28 and/or other materials specified by the Board or its designee.

1. PREMISES AFFECTED

2. APPLICANT NAME

If a Corporation, LLC, Trust or other entity, please provide name of authorized

signatory and title

3. MAILING ADDRESS

4. TELEPHONE

5. EMAIL ADDRESS

6. NAME OF AUTHORIZED REPRESENTATIVE

ADDRESS

TELEPHONE

7. APPLICATION FOR SPECIAL PERMIT IS MADE AS PROVIDED FOR IN SECTION

IN ACCORDANCE WITH SECTION OF THE ZONING ORDINANCE.

8. ZONING DISTRICT

9. HAS EITHER A VARIANCE OR LICENSE BEEN REQUESTED FOR THE PREMISES AFFECTED?

YES NO IF YES A COPY OF THE DECISION OR APPLICATION MUST BE

FILED WITH THE BOARD.

PLANNING

BOARD

LAWRENCE

MASSACHUSETTS

10. DESCRIPTION OF PROPOSED / EXISTING STRUCTURE:

a. LOT SIZE s.f., BUILDING SIZE s.f.,

HEIGHT BY STORIES FEET

b. OCCUPANCY OR USE OF EACH FLOOR

11. SIGN SIZE X , HEIGHT feet

TOTAL SIGN AREA s.f.

SIGNATURE _______________________________________ DATE_________________________________

THE LAWRENCE ASSESSORS’ OFFICE

INSTRUCTIONS TO PETITIONERS FOR ABUTTERS LISTS

The City of Lawrence mails a NOTICE OF HEARING and NOTICE OF DECISION to all parties in

interest within three hundred (300) feet of the property line of the petitioner's property.

To prepare a complete application, the petitioner must:

1. Obtain the applicable tax map(s) for the site from the assessors office;

2. Identify the Parties in Interest, i.e., the petitioner/applicant, immediate abutters, owners

of land directly opposite on any public or private street or way and abutters to abutters

within three hundred (300) feet along the property sideline in an easterly or westerly

direction from the property lines of your site as they appear on the most recent

applicable tax list, notwithstanding that the land of any such owner is located in another

city or town.

3. List all the tax map numbers of the parcels identified above on the forms provided;

4. Prepare a typewritten list of abutters and their mailing address for certification by the city

tax assessor; and

5. Provide two (2) sets of mailing labels listing the property owner's name and certified

mailing address for each abutter identified through the above process. Your name, the

site owner's name and the site address should be at the top of the list.

NOTE:

a. Where a petitioner's property line is within three hundred (300) feet of an

adjacent town, the petitioner must also supply a certified list of abutters from the

adjacent town's tax assessor; the applicable tax map for verification; and

complete a label form for each abutter. All information must be typed on the

forms provided by the adjacent town.

b. Familiarize yourself with zoning requirements, because erroneous notification(s)

to abutters can jeopardize or invalidate your permit.

c. Use the attached forms and prepare your list carefully and neatly. All

information must be typed on the forms provided.

d. Every effort will be made to certify the listing you submit as soon as possible, but

the assessor has 10 days, after the receipt your written request, to verify the

owner's names and addresses supplied on your list.

e. The assessors maps utilized are for assessing purposes only: therefore, they are

not of survey accuracy. In the case of questionable parcels, you should include

any adjacent lots rather than eliminate one due to any difference in a scaled

dimension.

f. Our requirements are to certify your list as to accuracy of our "most recent

applicable tax list.” This certification does not include any recent transfers of

ownership that we have not received.

Please do not hesitate to ask either the requesting authority or your assessors should you have

any questions about your request for certification. Thank you.

LIST OF OWNERS TO RECEIVE NOTICE

PETITIONER:

MAILING ADDRESS:

SITE ADDRESS:

List all owners within Three Hundred (300) feet of the site.

ASSESSORS’

MAP LOT OWNER MAILING ADDRESS

Site:

Abutters:

For Tax Assessor's Use Only

According to our records of this date, certified by the CITY OF LAWRENCE BOARD OF ASSESSORS. This review is based upon our existing

parcel maps, which are compiled for assessing purposes only; therefore, they are not drawn to survey accuracy for conveyances. This

certification does not include any recent transfers of ownership that have not been received by the assessor's office. Every effort has been

made to maintain these records as legally required.

__________________________________________

Tax Assessor's Signature Date

page ___ of ___ . __________________________________________

Typed Name and Title

IMPORTANT

** INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.

** APPLICANT OR APPLICANT’S REPRESENTATIVE IS SOLELY RESPONSIBLE FOR

COMPLETION OF THE APPLICATION AND FULFILLMENT OF ALL

REQUIREMENTS, NOT THE BUILDING COMMISSIONER, LAND USE PLANNER

NOR THEIR STAFF.

** THE BUILDING COMMISSIONER, LAND USE PLANNER AND THE PLANNING

BOARD RESERVES THE RIGHT TO REJECT INCOMPLETE APPLICATIONS AT ANY

TIME.

** THE PLANNING BOARD STRONGLY SUGGESTS CONTACTING THE ABUTTERS,

NEIGHBORHOOD GROUP, IF ANY, AND THE APPROPRIATE CITY

COUNCILLOR (S) OF THE SUBJECT PROPERTY FOR ADDITIONAL COMMENTS

AND INPUT, PRIOR TO COMPLETING AND SUBMITTING YOUR APPLICATION.

SPECIAL NOTICE

If you are or feel unable to complete the application as it is intended, you are advised to seek

assistance. Please be advised that neither the Building Inspector, the Land Use Planner, the City

Clerk nor their staff can help you with this matter.

The acceptance by the City Clerk of your application shall not be construed to mean that the

Board will accept it as being properly drafted.

Prior to hearing your petition, the Board will review it to ascertain if it is completed properly.

The Planning Board reserves the right to dismiss without prejudice any matter before it on the

basis of an incomplete application.

I _________________________________________ have read the application directions

(Applicant’s signature(s) and this special notice.

AUTHORIZATION OF REPRESENTATION

I/we owner(s)

of record of (address)

hereby authorize(s) (applicant)

and/or , (authorized representative)

to represent me/us/it before the Planning Board.

________________________________

Owner of Record’s signature

________________________________

Applicant’s signature

________________________________

Authorized representative’s signature

________________________________

Date

AUTHORIZATION OF REPRESENTATION

I/we , applicant (s)

of record of , (address)

hereby authorize(s) , (authorized

representative)

to represent me/us/it before the Planning Board.

________________________________

Applicant’s signature

________________________________

Authorized representative’s signature

________________________________

Date

SPECIAL PERMIT FOR RESTORATION OF EXISTING STRUCTURES

Application packages for the restoration of existing structures shall include photos of the existing

site, twelve renderings of the proposed restoration complete with elevations, a listing of the

materials to be used and color(s).

SPECIAL PERMIT FOR SIGNAGE

Application packages for signage shall include photos of the site, a plot plan depicting the

dimensions of the property, structure and storefront (if applicable), twelve renderings of the

proposed signage complete with dimensions, material(s) of proposed signage, color(s) of

proposed signage and lighting source.

SPECIAL PERMIT IN GENERAL

All Special Permit application packages shall include photos of the existing site.

ARTICLE VIII

SITE PLAN REVIEW AND APPROVAL REGULATIONS

Sec. 29-25. Applicability.

As specified in this ordinance, certain uses shall require site plan review by the planning board

and other uses shall require site plan approval by the planning board.

The purpose of site plan review and approval is to ensure that buildings and structures are prop-

erly located on a site in order to protect abutting properties from noise, fumes, glare of lights, and

other detrimental effects of a proposal; to preserve natural architectural, historical and other

valuable features on the site to be developed; and to provide for adequate traffic patterns, access

driveways, parking, sidewalks, loading facilities, drainage, solid waste disposal, sewer, and water

in order to protect the public health, safety and welfare.

Sec. 29-26. Site Plan Review.

A site plan review shall be advisory in nature and shall be without a public hearing but the

planning board shall determine whether the zoning provisions have been complied with, and shall

submit a report to the zoning board of appeals. No special permit shall be issued by the board of

appeals until receipt of this report, or the expiration of thirty-five days after receipt of the site plan

by the planning board without a report. In issuing a special permit, the zoning board of appeals

must find that a site plan review application was submitted to the planning board by the applicant.

Where site plan review is required for a use designated PSR in Section 29-11 (Table of Uses), the

planning board shall submit its report to the building commissioner who shall be the permit

granting authority (rather than the planning board, which report shall be advisory in nature to the

building commissioner in issuing a building permit for any such use. Site plan review under this

paragraph shall be in place of the site plan approval procedures set forth in Section 29-27. No

building permit shall be issued by the building commissioner until receipt of this report, or the

expiration of thirty-five days after receipt of the site plan by the planning board without a report.

In issuing a building permit for a PSR-designated use, the building commissioner must find that a

site plan review application was submitted to the planning board by the applicant. [amended

4/15/97]

Sec. 29-27. Site Plan Approval.

Site plan approval by the planning board, for cases requiring a special permit by said board as

noted in Sec. 29-11 (Table of Uses), shall require the planning board to hold a public hearing and

to follow the procedures as set forth for special permits under Article VII of this ordinance.

Site plan approval by the planning board shall also be required of all new construction, with the

exception of single and two-family structures, which does not otherwise require a special permit

from either the planning board or the zoning board of appeals. Said approval shall be without a

public hearing but the planning board shall determine:

(1) Whether the zoning provisions have been complied with,

(2) That the design of the building or structure is compatible with the architecture in the

neighborhood, and

(3) That the findings as per use have been met.

Sec. 29-28. Application and Procedures.

(a) Pre-submission review. Prior to the submission of a formal site plan, the applicant should meet in

person with the planning board's agent to discuss the proposal, in order to determine the

requirements necessary in developing and submitting the required site plan.

(b) Twelve copies of an application for site plan review or approval shall be submitted to the planning

board, each accompanied by a plan. The planning board shall submit copies of the application and

plan to other boards, agencies, and departments as provided by Section 29-24(i) for review and

comment within thirty-five days of receipt. In the case of site plan approval, the applicant shall be

responsible for first submitting the application and plan to the city clerk for date and time stamping in

order to start the time for processing of a special permit. For plans requiring site plan review, an

agent of the planning board shall date and time stamp the plans upon submission to the planning

board.

(1) Plans shall be prepared by a registered professional engineer, registered land surveyor,

registered architect, or registered landscape architect, as appropriate.

(2) Plans shall be on sheets no larger than 24 X 36 inches, at a scale of one inch equals 40 feet,

unless otherwise permitted by the planning board.

(3) Plans requiring more than one sheet shall include a key.

(4) The applicant shall provide all required information on as many sheets as are necessary in

order to clearly depict the required information and to prevent confusion; and all related

information shall be shown on one sheet wherever possible.

(5) Necessary information, unless otherwise permitted by the planning board, shall include:

(i) The names and addresses of all owners of record of all adjacent property, as appearing

on the most recent tax assessment list of the City.

(ii) Existing zoning district boundaries.

(iii) Boundaries of the property; yards and set-back lines as required in this ordinance, and

lines of existing streets, lots, reservations, easements and areas dedicated to public use.

All lengths shall be in feet and decimals of a foot, and all angles shall be given to the

nearest ten seconds or closer if deemed necessary by the surveyor. The error of

closure shall not exceed one to ten thousand.

(iv) A copy of any covenants or deed restrictions that are intended to cover all or part of the

tract and will become a part of any subsequent instruments of conveyance.

(v) Location of existing buildings.

(vi) Location of existing water mains, culverts and drains on the property, with pipe sizes,

grades and direction of flow.

(vii) Existing contours with intervals of five feet or less, referred to a datum satisfactory to

the planning board.

(viii) Location of existing water courses, marshes, rock outcrops, wooded areas, single trees

with a diameter of eight inches or more, measured three feet above the base of the

trunk, and other significant existing features.

(ix) Location of existing streets and ways which abut the proposal.

(x) Title of development, date, north point, scale, name and address of record owner,

engineer, architect, land planner or surveyor preparing the site development plan.

(xi) The proposed use or uses of land, buildings, and structures and proposed location of

buildings and structures, including proposed grades, elevations, and facade treatment

of all proposed buildings and structures.

(xii) All proposed lots, easements, and public and community areas.

(xiii) All proposed streets with profiles indicating grading and cross-sections showing width

of drives or roadway, location and width of sidewalks, and location and size of utility

lines, according to the standards and specifications of the City of Lawrence. All

lengths shall be in feet and decimals of a foot, and all angles shall be given to the

nearest ten seconds or closer if deemed necessary to the surveyor. The error of closure

shall not exceed one to ten thousand.

(xiv) All means of vehicular ingress and egress to and from the site onto public or private

streets or ways.

(xv) The location and design of any off-street parking areas or loading areas.

(xvi) The location of all proposed water lines; valves and hydrants and all sewer lines or

alternative means of water supply or sewage disposal and treatment.

(xvii) The proposed location, direction, power, and time, of proposed outdoor lighting.

(xviii) The proposed screening and landscaping, including a planting plan prepared by a

qualified landscape architect or architect, if required by the planning board.

(xix) Proposed storm water drainage system together with engineering calculations for a 10-

year storm.

(xx) Proposed grading, including erosion control plans.

(xxi) For plans requiring site plan approval, the planning board may require the submission

of additional studies such as traffic studies, drainage studies, economic studies, or

environmental studies to enable it to complete its approval process and make the

required findings. The planning board shall determine the scope of such studies.

(6) The application, whether for review or approval, shall be accompanied by the required filing

fee as specified in the rules and regulations of the planning board when acting as a special

permit granting authority.

(7) The application shall be accompanied by a copy of all other approvals, permits, variances,

orders of conditions, licenses, and applications to other boards or to the state or federal

government.

(8) The application shall be signed by the property owner , or the owner's agent with proof of

authorization to act as agent.

(9) Elevations depicting facade design, color scheme and use of materials shall be submitted.

(d) Contents of site plan – existing structure.

(1) Plans shall be prepared by a registered professional engineer, registered land surveyor,

registered architect, or registered landscape architect, as appropriate.

(2) Plans shall be on sheets no larger than 24 x 36 inches, at a scale of one inch equals 50 feet,

unless otherwise permitted by the planning board.

(3) Plans requiring more than one sheet shall include a key.

(4) The applicant shall provide all required information on as many sheets as are necessary in

order to clearly depict the required information and to prevent confusion; and all related

information shall be shown on one sheet wherever possible.

(5) Necessary information, unless otherwise permitted by the planning board, shall include:

(i) The names and addresses of all owners of record of all adjacent property, as appearing

on the most recent tax assessment list of the City.

(ii) Existing zoning district boundaries.

(iii) Boundaries of the property; yards and set-back lines as required in this ordinance, and

lines of existing street, lots, reservations, easements and areas dedicated to public use.

All lengths shall be in feet and decimals of a foot, and all angles shall be given to the

nearest ten seconds or closer if deemed necessary by the surveyor. The error of

closure shall not exceed one to ten thousand.

(iv) A copy of any covenants or deed restrictions that are intended to cover all or part of the

tract and will become a part of any subsequent instruments of conveyance.

(v) Location of existing buildings.

(vi) Existing contours with intervals of five feet or less, referred to a datum satisfactory to

the planning board.

(vii) Location of existing water courses, marshes, rock outcrops, wooded areas, single trees

with a diameter of eight inches or more, measured three feet above the base of the

trunk, and other significant existing features.

(viii) Location of existing streets and ways which abut the proposal.

(ix) Title of development, date, north point, scale, name and address of record owner,

engineer, architect, land planner or surveyor preparing the site development plan.

(x) All proposed easements and rights of ways.

(xi) All means of vehicular ingress and egress to and from the site onto public or private

streets or ways.

(xii) The location and design of any off-street parking areas or loading areas.

(xiii) The location of all proposed water lines; valves and hydrants and all sewer lines or

alternative means of water supply or sewage disposal and treatment.

(xiv) The proposed location, direction, power, and time of proposed outdoor lighting.

(xv) The proposed screening and landscaping, including a planting plan prepared by a

qualified landscape architect or architect, if required by the planning board.

(xvi) Proposed storm water drainage system together with engineering calculations for a 10-

year storm.

(xvii) Proposed grading

(xviii) For plans requiring site plan approval, the planning board may require the submission

of additional studies such as traffic studies, drainage studies, economic studies, or

environmental studies to enable it to complete its approval process and make the

required findings. The planning board shall determine the scope of such studies.

(6) The application, whether for review or approval, shall be accompanied by the required filing

fee as specified in the rules and regulations of the planning board when acting as a special

permit granting authority.

(7) The application shall be accompanied by a copy of all other approvals, permits, variances,

orders of conditions, licenses, and applications to other boards or to the state or federal

government.

(8) The application shall be signed by the property owner, or the owner's agent with proof of

authorization to act as agent.

(e) Required matters for review or required findings for approval.

(1) The plan complies with all use, dimensional, parking, and loading requirements of the

ordinance.

(2) The traffic layout provides maximum safety of traffic circulation, ingress and egress, including

adequate streets, entrances and exits, traffic flow, sight distances, curb cuts, turning lanes, and

signalization.

(3) Proposed lighting (including the location, power, direction and time of any outdoor lighting of

the site) have no adverse effect upon any adjoining properties by impairing the established

character, or the potential use, of such properties.

(4) Proposed screening and landscaping will adequately screen, at all seasons of the year, all

parking and service areas from the view of adjacent properties and streets and will be in

character with the surrounding area.

(5) The improvements and amenities if required, are to be installed on the property at the expense

of applicant and shall assist in the establishment of a sound, urban environment. Such

improvements shall include but not be limited to granite curbing, portland cement sidewalks,

and street trees, where required.

(6) Proposed sidewalks, and other amenities will provide maximum pedestrian and bicycle safety

and access.

(7) Proposed off-street parking and loading is adequately located to serve the proposed use

conveniently and safely.

(8) The proposed method of sewage disposal, refuse disposal, or solid waste disposal will provide

a clean, healthy, and safe environment, and is of adequate size and design to meet the needs of

the proposed use.

(9) The proposed water supply system is designed in a manner to provide adequate potable water

and with sufficient pressure to enable safety in case of fire or other water-dependent

emergencies.

(10) Proposed grading of the site will be minimal and erosion will be prevented by protective

measures.

(11) Proposed storm water drainage is based upon a 10-year storm intensity occurrence, utilizing on

site absorption wherever practical, and taking into account the contour of the land.

(12) Emergency vehicle access, including, but not limited to, fire, police, and highway departments

is possible based on adequate turning radius and access widths.

(13) Proposed utility lines are located so as to be aesthetic and safe.

(14) Buildings and structures are of a scale and design so as to blend with the site and the surround-

ing neighborhood, and are located and configured on the site in such a manner as to be in

character with the surrounding neighborhood.

(15) All significant architectural, natural, historical, archaeological, or other valuable features on

the site have been preserved.

(16) The proposal will not create any unnecessary pollution, noise, odor, or glare.

(f) After acting upon a site plan review application, the planning board shall submit one copy of its

report to the board of appeals and one copy to the applicant.

After acting upon a site plan review application for a PSR-designated use, the planning board shall

submit one copy of its report to the building commissioner and one copy to the applicant. [amended

4/15/97]

CHECKLIST

SPECIAL PERMIT REQUIREMENTS

(see Sec. 29-24 - Lawrence Zoning Ordinance)

SITE PLAN APPROVAL REQUIREMENTS

(see Sec. 29-27 - Lawrence Zoning Ordinance)

SITE PLAN REVIEW REQUIREMENTS - HIGHWAY ACCESS DISTRICT

(See Sec. 29-26 and Sec. 29-28 - Lawrence Zoning Ordinance)

NOTE: This form is to be completed by the petitioner and/or authorized representative and a

copy is to be attached to each application package.

Please check

as attached.

I. APPLICATION. ____________

12 copies

mandatory

1. MUST be typewritten and completed by petitioner or representative.

2. Petitioners are responsible for obtaining the abutters list. The Building Commissioner will

provide you with the Map and Lot #s from the Real Estate Assessor's Map. Subsequently,

you shall obtain the abutters names and addresses from the Assessor's Office; after the list

is completed by the applicant, the Board’s Administrative Assistant will notify the abutters

listed. The Assessor's list may not be updated, therefore the Board strongly recommends

that you personally notify your immediate abutters.

3. MUST have all pertinent information noted, including owners names and signatures.

4. Incomplete applications will not be accepted.

II. CERTIFIED SITE PLANS. ___________

(see Article VIII of Zoning Ordinance) 12 copies

mandatory

1. MUST be prepared, sealed and signed by one of the following:

a. Registered Professional Engineer

b. Registered Professional Land Surveyor

c. Registered Professional Architect

d. Registered Professional Landscape Architect

NOTE: A certified Site Plan is not required for Special

Permit signage applications:

Special Permit signage applications shall include the graphic information

specified in the attached hand-out shown at a scale and format acceptable

to the Lawrence Planning Board. ____________

12 copies

mandatory

III. FOR SPECIAL PERMIT/SITE PLAN APPROVAL REQUESTS ONLY:

SITE PLAN APPROVAL:

1. If proposed use requires a SITE PLAN APPROVAL, then the Special Permit Granting

Authority is the Lawrence Planning Board and proper procedures for requesting a meeting

with the Board shall be met.

2. If proposed use requires a SITE PLAN APPROVAL, the applicant must meet in person with

the Planning Board's agent to discuss preliminary site plan(s), technical matters relative to

zoning and planning, required documentation, and the proper completion of the application

package for Special Permit.

REFER TO ARTICLES III, VII AND VIII OF THE LAWRENCE

ZONING ORDINANCE FOR ADDITIONAL INFORMATION.

IV. COPY OF LETTER OF REFUSAL OR DENIAL OF BUILDING

PERMIT BY THE BUILDING COMMISSIONER.

____________

12 copies

mandatory

V. COPY OF PREVIOUS ZONING AND/OR PLANNING DECISIONS

INCLUDING VARIANCES, SPECIAL PERMITS, AND/OR SITE PLAN

APPROVAL, ZONING VIOLATIONS, COURT ORDERS, AND/OR

BUILDING PERMITS IF ANY.

__________

12 copies

mandatory

VI. COPY OF THE MOST RECENT DEED (CURRENT OWNER(S))

RECORDED AT THE NORTH ESSEX REGISTRY OF DEEDS.

(Include Book and Page numbers or Instrument number of Recording.)

____________

12 copies

mandatory

Note: This information is not required for signage permits.

VII. PHOTOGRAPHS OF ENTIRE SITE. __________

(different views, if necessary) one original

plus 11

photocopies

of each

mandatory

VIII. CERTIFIED CHECK, CASHIERS CHECK OR MONEY ORDER ONLY.

(No personal checks or cash accepted.)

____________

see fee

schedule

IX. COPY OF THE AUTHORIZATION FORMS.

____________

12 copies

mandatory

X. DATE AND SIGNATURE(S) *** MANDATORY ***

Including: property owner

applicant (if different) and

applicant's representative.

LAWRENCE PLANNING BOARD

FEE SCHEDULE

SPECIAL PERMIT $250.00 PAYABLE TO THE CITY OF LAWRENCE

$200.00 PAYABLE TO THE EAGLE TRIBUNE

(for advertising expenses)

SITE PLAN APPROVAL $250.00 PAYABLE TO THE CITY OF LAWRENCE

$200.00 PAYABLE TO THE EAGLE TRIBUNE

(for advertising expenses)

SITE PLAN APPROVAL $250.00 PAYABLE TO THE CITY OF LAWRENCE

Amendments $200.00 PAYABLE TO THE EAGLE TRIBUNE

(for advertising expenses)

SITE PLAN REVIEW $250.00 PAYABLE TO THE CITY OF LAWRENCE

(with a public meeting) $200.00 PAYABLE TO THE EAGLE TRIBUNE

(for advertising expenses)

APPROVAL NOT REQUIRED $ 50.00 per lot (Buildable or not)

PRELIMINARY $ 50.00 per lot

SUBDIVISION PLANS plus $.44 per abutter

DEFINITIVE $150.00 per lot

SUBDIVISION PLANS plus $.44 per abutter

*******************************************************************************

The applicant shall pay for any study requested by the Board.

The applicant shall pay for all costs associated with the Registry of Deeds

Payment will be made to the City of Lawrence/Eagle Tribune by Money Order or a Certified

Check.

Effective 9-17-10

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