Upload
others
View
4
Download
0
Embed Size (px)
Citation preview
RETURN THIS APPLICATION VIA EMAIL
Harmoni Towers10802 Executive Center Drive Little Rock, AR 72211
E-mail: [email protected]: 501.850.0820
Application Submission Date:
Proposed Install Date:
Proposed On Air Date:
UNITI SITE INFORMATION:
Uniti Site Name: Street Address:
Uniti Site Number: City:
Uniti Site Description: State:
Customer Site Name: Zip:
Latitude: County:
Longitude:
APPLICANT INFORMATION:
Applicant Name: Primary Contact Name:
Applicant Title: Company Name:
Applicant Phone: Primary Contact Phone:
Applicant Email: Primary Contact Email:
Legal EntityContract: Primary Contact Address:
Applicant Address (city, state, zip):
Notice Address:
Billing Address:
SITE LICENSE APPLICATION
CUSTOMER / CARRIER INFORMATION:
Leasing Contact Name/Number/E-mail:
RF Contact Name/Number/E-mail:
Legal Review Contact Name/Number:
Zoning Contact Name/Number:
Construction Contact Name/Number:
Site Tech Contact Name/Number:
Emergency Contact Name/Number:
Harmoni Towers Site License Application
DocuSign Routing:
DocuSign Routing:
Harmoni Towers Site License Application
Sector Arrangement Antenna Position
North
Sector X
1 2 3 4A B C
North most sector
**PLEASE ATTACH SPEC SHEETS FOR ALL ANTENNAS & EQUIPMENT.
ANTENNA / MW INFORMATION (Make & Model): RADIOS & AMPS (Make, Model, ie RRU, TMA) RAD CENTER (ft) AZIMUTH (deg) TRANSMISSION LINE
Antenna Position:
Technology & Frequency
Make & Model Existing
Make & Model New
Make & Model Existing
Make & Model New Existing New Existing New
Cable Length
(ft)
CableDiameter
(in)
Make & Model Number
Sect
or 1
1
A
2
B
3
C
4
Sect
or 2
1
A
2
B
3
C
4
Sect
or 3
1
A
2
B
3
C
4
ANTENNA / MW INFORMATION (Make & Model): RADIOS & AMPS (Make, Model, ie RRU, TMA) RAD CENTER (ft) AZIMUTH (deg) TRANSMISSION LINE
Antenna Position:
Technology & Frequency
Make & Model Existing
Make & Model New
Make & Model Existing
Make & Model New Existing New Existing New
Cable Length
(ft)
CableDiameter
(in)
Make & Model Number
Sect
or 4
1
A
2
B
3
C
4
Sect
or 5
1
A
2
B
3
C
4
Sect
or 6
1
A
2
B
3
C
4
Harmoni Towers Site License Application
CUSTOMER / CARRIER INFORMATION:
Equipment Enclosure Type: BTS Cabinets/Number of BTS Cabinets:
Outdoor Shelter:
Other:
Leased Area Dimensions (WxD) (ft)
Cabinet/BTS/Shelter Dimensions (HxWxD) (ft):
Concrete Pad Dimensions (WxD) (ft):
Cabinet/Shelter Manufacturer/Model:
POWER REQUIREMENTS:
AC Power:Required
Voltage and TotalAmperage:
GENERATOR INFORMATION:
Generator Ground Space Requirement (HxWxD) (ft) Fuel Type:
Propane
Diesel
Natural Gas
Fuel Tank Size (Gallons): Fuel Tank Location:
Attached
Separate
None
Capacity (KW):
ADDITIONAL INFORMATION / COMMENTS:
• Ground lessor consent may be required as a condition to the executionof your lease.
• Modifications to the tower site may be subject to local zoning approval.
• **Attach manufacturer’s equipment specifications for antennas, radios,amps, mounts, cabinets, shelters, etc.
• Contact [email protected] with questions.
Harmoni Towers Site License Application
Harmoni TowersSITE LICENSE APPLICATION