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HomeMy WebLinkAboutZ-6937-C Applicationa t & t November 7, 2011 AT&T site Name: Baptist Hospital AT&T Site Number: AR1470 Site Address: 9601 Lile Drive Type of Installation: Roof Top Company Name T: 123.456.7890 1234 Street Name, Suite 123 F: 123.456.7891 City Name, ST 12345 6789 www.att.com The Equivalent Isotropically Radiated Power (EIPR) for this installation is 500 watts or less. The current FCC rule (reference: Code of Federal Regulation, Title 47 - Telecommunications, Chapter 1 -Federal Communications Commission, Part 24 -Personal Communications Services, Subpart E -Broadband PCS, Section 24.232 -Power and antenna limits). This installation, as designed, meets the FCC requirements. 11'Z 7 enior Manager Real Estate & Construction Date `CX.Y Proud Spanwi 01 the VS. Olympic Te -m WCF.dca AFFIDAVIT 03/01110 certify by my signature below that I hereby authorize act as my agent regarding (lie �irci�RCS Cnrr�l�tu� e `tsr�?�•c' 1' f the below described property. Property described as:�� 'VO -0\ -A AVA e Signature of Title Holder LV Date Subscribcd :ind sworn to me a Notary Public on this . ,,j51{i1111Il177��'�,, o ; CECELIA z: A. WRIGHT � N No.12345987 COMM. EXP. r ,�-a•2trts ''11,11n11n10 My Commission Expires: // r'9 ,-1 S— / Ar2G day of Notary Public WCFAm 03/01/10 WIRELESS COMMUNICATION FACILITY (WCF) APPLICATION WCF CASE FILE NO.. Z- ADDRESS: CI C7 LEGAL DESCRIPTION: ZONING CLASSIFICATION: CIPA UTTING RESIDENTIAL- YES NO PROPERTY LOCATED IN FLOODPLAIN DISTRICT: YES ')(- NO ATTACHED: OR WITH SUPPORT STRUCTURE: Maximum Setbacks: Height Front Setbacks: Setbacks: Rear Sides Platted Buildine Line Allowed, WCF Tower Proposed Allowed, Equipment Structure Proposed J SECURITY FENCING HEIGHT: IQ FaG 1 C -oz LIGHTING: YES ✓ NO DOWNSHIELDED: LANDSCAPE PLAN ATTACHED: ERP INFORMATION ATTACHED: 1 COLLOCATION STATEMENT/AGREEMENT ATTACHED: ADDITIONAL DEVELOPMENT STANDARD INFORMATION: -F S d APPLICANT NAME: (please print APPLICANT ADDRESS: t I ❑ APPLICANT PHONE NO.-. ,i"% '�r S 4 t 2 3 FA NO: L5i7 C; } p 12 Z 2 APPLICANT SIGNATURE: Date Received: Any information not provided regarding Easement Clearance: pproved / nied easement or floodway/plain, which impacts the decision regarding this application is the Application: p rov 1 nied responsibility of the applicant. NOTE: OBTAIN A BUILDING PERMIT BEFORE BEGINNING ANY CONSTRUCTION. SUBMIT COPY OF THIS APPROVED APPLICATION AND ORIGINAL SIGNED SITE PLAN WITH SUBMITTAL. COMMENTS. DATE: l PLANNING OFFICIAL: Ic 1.6rl< r ✓J.I & ® Ip Im ®to Yom. f •• a L D 21 am D U B O DR z LU � � �� ® ®Ijmt D 1, 11 ®*Oil VAGH DR � - ■ LLJ U Z) p O�t=TTE D ® ®[rIF p a �■s ® LE 0 ■ v °�®� ®®®�� �r CCI= €3� ,MI GOODMAN NETWORKS, INC. City of Little Rock 07-NOV-11 WR 1470 WCF AD] Total: $100.00 $100.00 10898 City of Little Rock Planning and Development Filing Fees Datej D , 20 _L Annexation $ Board of Adjustment $ Cond Use Permit/T U P wcr— $ Final Plat $ Planned Unit Dev $ Preliminaiy Plat $ - Special Use Permit $ Rezoning $ `� Site Plans $ Stieet Name Change Street Name Signs - Number at ea Public Hearing Signs Number at ea $ Total $ File No Location i 1 Applicant �MA� Z i By