Fillable CELL TOWER APPLICATION CHECKLIST 1. Application 3. Coverage (City of South Bend)

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CELL TOWER APPLICATION CHECKLIST 1. Application 3. Coverage (City of South Bend)

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CELL TOWER PERMIT APPLICATION PACKAGE
CELL TOWER APPLICATION CHECKLIST
☐
1. Application
☐
2. Site Plan showing location of tower, setbacks, distance from residential uses, all existing structures, and
proposed changes.
☐
3. Coverage area map if a part of a special use/exception or variance approval
☐
4. Special use/exception and/or variance approvals if applicable http://www.sjcindiana.com/apc
☐
5. Construction plans
NEW CELL TOWERS
If applying to construct a new tower, submit application to:
Area Plan for County Properties: http://www.sjcindiana.com/formcenter/area-plan-commission-forms-23/cell-tower-permit-application-89
City Zoning for City Properties: https://southbendin.gov/department/community-investment/planning-community-resources/zoning/
ADDITIONS & SUBSTANTIAL CHANGES TO EXISTING TOWERS
If making additions or substantial changes to existing cell towers, complete Sections 1 through 4 below and submit
application to the Building Department. *Permits are not required for work on external parts of antennas.
SUBSTANTIAL CHANGES TO EXISTING TOWERS
If making substantial changes to an existing tower, current development standards must be met and/or variances
must be applied for. A substantial change includes the following:
1. If new tower height is more than 10% higher than current height
2. If the tower is proposed to exceed 200ft
3. If the total number of cabinets for this application exceeds 4
4. If the distance between the new antenna and the antenna below it is less than 20 feet
5. If a new appurtenance protrudes 20 feet or more than the width of the tower at the point of installation (whichever
is greater)
6. If the compound is being expanded more than 2,500 sq/ft
7. If excavation is required outside of the boundaries of the leased of owned property or to any access or utility
easements related to the site
8. If you are making substantial changes that cause the tower to be less then 500ft from a residential use or district
9. If you are doing any electrical work that is not considered maintenance (work must be performed by an electrical
contractor licensed with our department)
DEMOLITION OR REMOVAL OF CELL TOWER OR EQUIPMENT
If demolishing a tower or removing equipment permanently fill out Sections 1-3 and sign at the end of Section 4.
WORK NOT REQUIRING PERMITS
If swapping out existing equipment or doing work that is considered maintenance no permit is required. If you are
not sure of what is considered maintenance feel free to contact us.
*Permits are not required for work on external parts of antennas.
CELL TOWER PERMIT APPLICATION
Page | 2 of 4
HELPFUL LINKS
CURRENT DEVELOPMENT STANDARDS
City of South Bend visit https://southbendin.gov/department/community-investment/planning-community-resources/zoning/
St. Joseph County visit http://sjcindiana.com/DocumentCenter/View/1425
State Codes visit https://statecodesfiles.justia.com/indiana/2015/title-8/article-1/chapter-32.3/chapter-32.3.pdf
Variance & Special Exception/Use Information http://www.sjcindiana.com/apc
SECTION 1. APPLICANT/OWNER INFORMATION
APPLICANT:
ORG/BUSINESS:
PHONE:
EMAIL:
ADDRESS:
Address
City
State
Zip
PROPERTY
OWNER:
PHONE:
EMAIL:
ADDRESS:
Address
City
State
Zip
SECTION 2. PROPERTY INFORMATION
ADDRESS:
Address
City
Zip
Township
ZONING:
VARIANCE, SPECIAL USE/
EXCEPTION APPROVAL
☐ N/A ☐ YES
Zoning
Approval Date
• Cell Towers within the City have Use Specific Standards.
• For zoning and variance/special exception information visit https://southbendin.gov/zoning/
• Confirm if they are special exception in the COUNTY here http://sjcindiana.com/383/St-Joseph-Zoning-Ordinance
•
For variance/special exception information visit http://www.sjcindiana.com/apc
OVERLAY: ☐ YES ☐ NO DESIGN APPROVAL ☐ N/A ☐ YES
If your property is in an Overlay the designs must be submitted to the Design Review Specialist for approval.
Approval Date
ENCROACHING IN
PUBLIC ROW
☐ YES ☐ NO
PUBLIC WORKS
APPROVAL
☐ N/A ☐ YES
If “yes” your designs must be submitted to Public Works for approval before a permit can be issued.
Approval Date
HISTORIC
DISTRICT:
☐ YES ☐ NO HISTORIC APPROVAL ☐ N/A ☐ YES
If your property is in an Historic District the designs must be approved by Historic Preservation.
Approval Date
FLOOD PLAIN OR
WETLAND:
☐ YES ☐ NO
FLOODPLAIN/WETLAND
APPROVAL
☐ N/A ☐ YES
If your property is in a flood plain or wetland you will need prior approval from the applicable authority.
Approval Date
CELL TOWER PERMIT APPLICATION
Page | 3 of 4
SECTION 3. PROJECT INFORMATION
PROJECT TYPE: VALUE $
☐ NEW
☐ ADDITION*
☐ REMOVAL
SECTION 4. ADDITION TO EXISTING TOWER
SECTION 4.1. ADDITIONS/CHANGES
# OF NEW
PLATFORMS
# OF NEW
CABINETS
# OF NEW EQUIPMENT
SHELTERS
Current Tower Height
New Tower Height
Height of proposed
antenna from ground
(ft)
Distance of new antenna
from antenna below (ft)
Length of protrusion from
tower (ft)
W
idth of tower at location of
antenna (ft)
Is excavation required outside of the boundaries of the leased or
owned property or to any access or utility easements related to the
site?
☐ YES
☐ NO
Is the compound being expanded more than 2,500 sq/ft?
☐ YES
☐ NO
SECTION 4.2. EXPLAIN REASONS FOR ADDITIONS/CHANGES
If proposed additions/changes are considered a substantial change as defined in the application instructions at the
beginning of this application package complete Sections 4.3 to 4.6.
SECTION 4.3. LAND
LAND SIZE:
Current Area (sq/ft)
New Area (sq/ft)
New Length (ft)
New Width (ft)
New Other (ft)
SET BACKS:
From residential uses
**Must be >500ft**
Front Lot Line
(ft)
Side Lot line
(ft)
Side Lot line
(ft)
Rear lot line
(ft)
Other (ft)
SECTION 4.4. FENCING
FENCING:
BLACK VINYL COATED ☐ Yes ☐ No
Height (ft)
*Must be 6’-10’*
SECURITY WIRE ☐ Yes ☐ No
POINTED INWARD
AND DOWN
☐ Yes ☐ No
FENCE OPEN SPACE
*Affects landscaping*
☐
> 50%
☐
20%-50% ☐ < 20%
PROVIDING FENCING AS
REQUIRED
☐ YES ☐ NO
VARIANCE
APPROVAL
☐ N/A ☐ YES
Approval Date
CELL TOWER PERMIT APPLICATION
Page | 4 of 4
SECTION 4.5. LANDSCAPING
LANDSCAPING
PROVIDING
LANDSCAPING
AS REQUIRED
☐ YES ☐ NO
VARIANCE
APPROVAL
☐ N/A ☐ YES
Approval Date
SECTION 4.6. ACCESS DRIVE
ACCESS DRIVES AND
WALK WAYS
HARD SURFACE
AS REQUIRED
☐ YES ☐ NO
VARIANCE
APPROVAL
☐ N/A ☐ YES
Approval Date
I certify the above to be a true and accurate to the best of my knowledge.
APPLICANT SIGNATURE
DATE
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CELL TOWER APPLICATION CHECKLIST 1. Application 3. Coverage (City of South Bend)

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Completed 16 July 2020

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