COLLOCATION APPLICATION

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*Date:
*Full Name :
*Company Name:
*Address:
Address2:
*City:
*State:
*Zip:
*Phone:
Fax:
*Email:
*Site Address:
*Applicant Site Name:
*Site Number:
*Proposed Antenna Centerline:
FAA
FAA Study Number:
Latitude:
Longitude:
Ground Elevation :
Azimuths
Alpha:
Beta :
Gamma :
Antennas
Number of Antennas :
Manufacturer :
Model Number :
Coaxial Cable
Number :
Diameter :
Manufacturer :
Fiber Optic Cable
Number :
Diameter :
Manufacturer :
Frequencies
Transmit :
Receive :
Ground Space
Building :
Yes a building, the Pad Size:
(width x length)
Cabinet :
Yes a cabinet, the Pad Size:
(width x length):
Base Station Equipment :
Additional Requirements :
*Bold are required