VAP Urban Setting Designation Request Template - Cover Letter and Certified Professional Affidavit

Sep 1, 2026

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This template package provides a cover letter requesting Ohio EPA approval for an Urban Setting Designation (USD) under Ohio Administrative Code 3745-300-10(C). It includes a Certified Professional Affidavit with required attestations about CP qualifications, the submission purpose, compliance with applicable threshold criteria, and the accuracy and completeness of USD request materials and notice requirements. It also specifies attachment items and electronic submission instructions, including formatting, PDF bookmarking/indexing, file compression guidance, and document naming constraints for shape files delineating the USD area.

LanguageEnglish

CategoryLetters

FormatDOCX

Pages9

Reading Time3 min

AccessFree to download

Cover Letter and Request for Technical Assistance Template

Certified Professional Affidavit

Certified Professional Affidavit for USD Request

Attachments

Required Notice and Supporting Documentation

USD Location and Threshold Criteria Support

VAP USD Electronic Instructions

Submission Requirements and File Formatting

PDF and File Naming Rules

VAP Urban Setting Designation Request Template (Non-Grant) Section 1: Cover Letter and Request for Technical Assistance Template [DATE] Jeffrey Martin Division of Environmental Response and Revitalization Ohio Environmental Protection Agency 50 West Town Street P.O. Box 1049 Columbus, OH 43215 RE: Request for Urban Setting Designation for [Name of USD Project] located at [Physical Address of USD Property or Area], [insert County name] County Dear Jeffrey: The purpose of this letter is to inform you of my request for approval of an urban setting designation (USD) for the above mentioned [property or area] submitted in accordance with Ohio Administrative Code 3745-300-10(C). One electronic copy of the USD request has been submitted through Ohio EPA’s eBusiness Center at https://ebiz.epa.ohio.gov including all applicable shape files delineating the area of the USD. The [insert name of USD project] property is comprised of [number of parcels] parcel[s] totaling approximately [number of acres] acres and is located at [address or description]. I understand that the actual costs that Ohio EPA incurs in the reviewing and processing the USD request will be billed to my attention under Voluntary Action Program Technical Assistance, pursuant to OAC 3745-300-03(E). I am aware that I will be charged an hourly rate, plus fringe and overhead. This USD request is being made on behalf of [identify the name(s) of all the USD applicant(s)]. You may reach our project contact(s) at [contact’s telephone #(s) and e-mail address(es)]. Sincerely, [CP name and number] [Certified Professional Seal Stamp here] Attachments Section 3.0 Certified Professional Affidavit Certified Professional Affidavit for USD Request Pursuant to OAC 3745-300-05(E)(4), 3745-300-10(C)(2): for an urban setting designation request State of ) ) ss: County of ) I, [name of CP affiant], being first duly sworn according to law, states that, to the best of my knowledge, information, and belief: 1. I am an adult over the age of eighteen years old and competent to testify herein. 2. I am a Certified Professional (CP No.________), in good standing under Ohio Revised Code (ORC) Chapter 3746 and Ohio Administrative Code (OAC) Chapter 3745-300. My current CP certification expires on ________________________. I prepared or oversaw the preparation of an Urban Setting Designation (“USD”) request pursuant to OAC 3745-300-10(C)(1) and (C)(2) for property at [note the address, or otherwise describe, i.e., property that consists of approximately acres in the city of , County, Ohio.] [The USD property is also referred to as the “ USD Project.”] 4. The purpose of my submission of the [insert name of the USD project] USD request under this affidavit is to request the Ohio EPA director’s approval of a USD for the property as described in the USD request. 5. I affirm that the USD request meets the threshold criteria contained in OAC 3745-300 10(C)(1)(a) - (h), contains a true and accurate copy of the documents required to support my determination that the requested USD meets the threshold criteria including the legal description of the USD boundary submitted in a manner prescribed by the agency, and documents that notice of the request for USD approval was provided in accordance with OAC 3745-300-10(C)(2)(b). 6. I have read all of the standards of conduct for certified professionals in OAC 3745-300-05(E) and I am in compliance with the standards regarding this voluntary action opinion. 7. To the best of my knowledge, information and belief, the USD request and the associated information, data, documents, and reports submitted in support of the USD request, are true, accurate and complete. Further affiant sayeth naught. ______________________________ Signature of Affiant Sworn to me and subscribed in my presence this ____ day of ______________, 20___. ___________________

FAQs

What is the purpose of the USD cover letter in this template package?

The cover letter states the request for Ohio EPA approval of an urban setting designation (USD) submitted under OAC 3745-300-10(C), including project location and parcel/acreage information.

What must the Certified Professional Affidavit confirm?

The affidavit attests that the CP is properly certified and in good standing, prepared or oversaw the USD request, the submission meets OAC threshold criteria requirements, notice was provided as required, and that the supporting information and documents are true, accurate, and complete.

How should electronic copies be prepared and submitted for a USD request?

Submit electronic USD request documents via compact disc or through Ohio EPA’s eBusiness Center. Provide text documents as PDFs, bookmark/index each PDF by section, compress file sizes when possible, keep each PDF under 150,000 KB, and name files using only letters, numbers, dashes, and underscores with a maximum length of 25 characters.

Sep 1, 2026

Upload by Asher