TAG Colocation Application - Tower Access Group



|RETURN THIS APPLICATION TO: (E-MAIL IS PREFERRED) |Date Rec. by TAG: | |

|Tower Access Group, LLC | | |Revision Dates: | |

|993 Four Mile Road, Suite 1 |e-mail: |info@ | | |

|Richmond, KY 40475 |office: |859.623.5513 |Site Name: | |

|Attn: Colocation |fax: |859.623.5213 |Site Number: | |

|TAG SITE INFORMATION |

|Latitude: | | | |N |Existing Structure Type: | |

|Longitude: | | | |W |Existing Structure Height (ft AGL): | |

|Site Address: | |County: | |State: | |

|APPLICANT INFORMATION |

|Applicant (Carrier): | |Primary Contact Name: | |

|Applicant Site Name: | |Company Name: | |

|Applicant Site Number: | |Primary Contact Number: | |

|Entity Name On Lease: | |Primary Contact Email: | |

|Notice Address On Lease: | |Primary Contact Address: | |

| | | | |

| | |Required Date For Receipt of Agreement: | |

|Billing Address: | |Proposed Installation Date: | |

| | |Proposed On Air Date: | |

|ADDITIONAL CARRIER INFORMATION |

|Leasing Contact Name/Number/Email | |

|RF Contact Name/Number/E mail | |

|Legal Review Contact Name/Number: | |

|Zoning Contact Name/Number | |

|Construction Contact Name/Number: | |

|Emergency Contact Name/Number: | |

|ANTENNAS |

|Sector |Sector 1 |Sector 2 |Sector 3 |Sector 4 |AUX |

|Desired Rad Center (ft AGL) | | | | | |

|Antenna Quantity | | | | | |

|Antenna Manufacturer | | | | | |

|Antenna Model (Attach Spec Sheet) | | | | | |

|Weight (lbs per antenna) | | | | | |

|Antenna Dimensions (HxWxD) (in) | | | | | |

|ERP (watts) | | | | | |

|Antenna Gain (dB) | | | | | |

|Orientation/Azimuth (Degrees) | | | | | |

|Mechanical Tilt | | | | | |

|TMA Quantity | | | | | |

|Mount Mfg and Model (Attach Spec Sheet) | | | | | |

|Tower Mount Mounting Height (On Tower) | | | | | |

|Transmit Frequency (MHz) | | | | | |

|Receive Frequency (MHz) | | | | | |

|Number of Coax Cables (PER ANTENNA) | | | | | |

|Diameter of Coax Cables (in) | | | | | |

|Type of Service (i.e CDMA, iDEN, GSM, TDMA, PAGING): | |

Please Note: “AUX” can be used for Microwave, TTA, LNA, or GPS antenna information.

|GROUND SPACE REQUIREMENTS |

| | |

| |___ BTS Cabinets/Number of BTS Cabinets: |

|Equipment Enclosure Type: | |

| |___ Outdoor Shelter |

| | |

| |___ Other: |

|Leased Area Dimensions (HxWxD) (ft) | |

|Cabinet/BTS/Shelter Dimensions (HxWxD)(ft): | |

|Concrete Pad Dimensions (HxWxD)(ft): | |

|Cabinet/Shelter Manufacturer/Model: | |

|POWER REQUIREMENTS |

|AC Power: | | | |

| | |Required Voltage and Total Amperage: | |

|GENERATOR INFORMATION |

|Generator Ground Space Requirement | | | |

|(HxWxD)(ft): | |Fuel Type: |__ Propane ___ Diesel |

|Fuel Tank Size (Gallons): | |Fuel Tank Location: |__Attached __Separate __None |

|Capacity (KW): | | | |

|ADDITIONAL INFORMATION/COMMENTS/APPROVALS |

| |

| |

| |

| |

| |

| |

Please attach spec sheets for:

o Antennas/TMA’s/Diplexers/Microwave Dishes/GPS

o Antenna Sector Mounts

o Outdoor Equipment

o Outdoor Shelter

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download