City of Oakwood

SMALL CELL WIRELESS PERMIT APPLICATION

DIRECTIONS: The Applicant shall supply all information required by Chapter 955 of the city of Oakwood Codified Ordinances. Construction Permits must be conspicuously displayed at the work site and be available for inspection by authorized city personnel.
1. INSTALLATION TYPES
Small Cell Facilities (check at least one):
New Installation/Collocation
Replacement/Modification
Removal
Quantity of Small Cell Facilities
Wireless Support Structures (check at least one):
New Installation/Collocation
Replacement/Modification
Removal
Quantity of Wireless Support Structures
If Collocation, name of the existing Wireless Support Structure owner
2. APPLICANT INFORMATION
(a) Operator/Utility Provider
Company Name:
Address:
Contact Person:
Phone Number:
Cell Number:
Email:
(b) Permit Agent, if different than Operator
Company Name:
Address:
Contact Person:
Phone Number:
Cell Number:
Email:
Is applicant the Operator of the proposed Small Cell Facility and/or Wireless Support Structure? Yes No
If “No”, is applicant serving as an agent for the Operator? Yes No
If “Yes”, applicant must provide written documentation of the agent designation signed by the Operator.
3. INSTALLATION LOCATION(S)
(a) Small Cell Facilities site coordinates & approximate street address (Latitude/Longitude):
(b) Wireless Support Structures site coordinates & approximate street address, if different than 3(a) (Latitude/Longitude):
4. ANTICIPATED CONSTRUCTION SCHEDULE
(a) Upon approval, construction start date:
(b) Completion date: