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3. Ordinance Code 151.45(B). Incomplete applications will not be accepted.
5. Owner/Applicant
7. Mailing Address
9. City
10. State
11. Zip Code
13. Phone
14. Email
16. Project Site
17. Zoning
21. Provide copy of site plan application in accordance with the site plan requirements, Section 46 of the City’s Comprehensive Zoning Ordinance.
22. Provide copy of current, valid FCC Amateur Radio license, or other license for operation of Amateur Radio facility.
24. Provide site plan sketch showing all proposed structures (e.g., support structures, anchorage) and setbacks from such structures to property boundaries.
25. Provide evidence that the proposed facility meets or exceeds FCC Guidelines for radio frequency radiation exposure.
27. Legal, principal use on the site (e.g., a residence)?
29. Maximum height of proposed antenna facility (if retractable, identify maximum height when retracted and maximum height when fully extended)
31. Maximum voltage in ground grid and/or the Tower
35. Contractor (if none, state “None”)
36. Contact
38. Mailing Address
40. City
41. State
42. Zip Code
44. Phone
45. Email
49. • Amateur Wireless Facility Special Permit: $25 per structure
    • Inspections: $65 each

51. I certify, under penalty of perjury, that the proposed antenna facility described by this permit application will be erected in accordance with manufacturer’s recommendations and that the proposed facility complies with all applicable deed restrictions (I.e., restrictive covenants), if any. I further certify that all of the information contained in this application is true and correct.

    I understand and agree that no antenna facility in any residential zoning district may have affixed or attached in any way except during time of repair or installation any lights, reflectors, flashers, or other illuminating device, except as required by the FAA, nor shall any tower have constructed thereon, or attached thereto, in any way, any platform, catwalk, crow’s nest, or like structure, except during periods of construction or repair.

    I understand and agree that the use of any portion of the antenna facility for signs other than identification, warning or equipment information signs is prohibited.

    I understand and agree that all abandoned or unused antenna facilities and associated facilities must be removed within twelve (12) months of the cessation of operations at the site unless a time extension is approved by the city. In the event that a tower is not removed within twelve (12) months of the cessation of operations at the site, I understand and agree that the tower and associated facilities may be removed by the city and the costs of removal assessed against the property.

    I understand and agree that the antenna facility is subject to inspection at least once each year by a designated official of the city to determine compliance with original construction standards, and that any deviation from original construction for which a permit is obtained constitutes a violation of the city’s antenna facilities ordinance.

    I understand that if any of the information provided is incomplete or incorrect the permit may not be issued or may be revoked by the building official. I hereby authorize access to the property for any issue related to this permit application.

53. Applicant's Name as Signature
54. Date
    Date
56. Sworn to and subscribed before me on this
57. day
58. of (month),
60. (year),
61. to certify which witness my hand and official seal.
63. Notary Public, State of Texas (Name as Signature)
64. My commission expires
    My commission expires
68. Permit

    1. Amateur Wireless Facility approved as submitted
    2. Applicant may erect amateur wireless facility pursuant to this application with required City modifications
    3. Permit Denied
70. Fees
71. Paid?

    1. Yes
    2. No
72. Required City Modifications
74. Note:

    All approved permits are subject to annual inspection by the City.

76. Issued by
77. Date
    Date
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