<p>TELECOMMUNICATIONS FACILITIES PROPOSAL </p><p>SUPPLEMENTAL INFORMATION SHEET</p><p>Applicant Name: ______</p><p>Carrier Name: ______</p><p>Site Name: ______</p><p>Site Address: ______</p><p>Tower or Structure owner ______</p><p>Tower or Structure Latitude/Longitude: ______</p><p>Site ground elevation: ______</p><p>Antenna height AGL: ______</p><p>Frequencies to be used: ______</p><p>Maximum ERP: ______</p><p>FCC Emission Designator: ______</p><p>Under what section of the FCC’s rules is the carrier licensed: ______</p><p>Along with the site plan information required for the application, please also attach an elevation profile of structure, tower, or monopole indicating heights of proposed antennas, existing antennas (w/carrier names and antenna type), heights designated for future attachments, and any equipment shed or cabinet, ice bridge, cabling, etc. If site is on an existing building, indicate location of other existing or approved carrier facilities, antennas, and equipment. Will this site be submitted for FAA review and approval? (If FAA review has already been completed please attach a copy or approval). </p><p>Please provide color RF propagation maps of the service area with and with out the proposed antennas. Please identify and include all adjacent antenna sites serving this area and identify the main arterial roadways. Please show expected coverage contours of expected signal levels at the desired level of service and plus and minus 5dB. If the application is for a new structure, how many additional carriers may be accommodated on the facility?______Please identify alternative locations or structures within a one mile radius from the proposed site which were considered for the placement of the antennas, monopole, or tower along with an explanation as to why they could not be used to accommodate the carriers antennas. Include supporting RF maps with and without the alternatives which demonstrate why the alternatives would not work, or, if there were non-RF reasons why those alternatives wouldn’t work, an explanation of why they could not be used.</p><p>If an existing structure is proposed to be modified to accommodate the antennas, please attach the structural engineering certification.</p><p>Please explain the extent to which the proposed sitings are for coverage, capacity, or other service interests. </p><p>Provide a technical description of the services to be provided (. Provide a description of the geologic or topographic (i.e. hills, valleys, vegetation or trees, etc.) affecting selection of this site. </p><p>Provide a description and specifications of the antennas and support structure proposed to be used. </p><p>If any drive tests, balloon tests, or other similar methods of analysis were used in selecting this site or rejecting an alternative site, please state the results of the tests. </p><p>Telecommunications Facilities Proposal Supplemental Information Sheet 3/01</p>