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ANTENNA SITE APPLICATION FORM <br /> Water Tower; Ramsey, Minnesota <br /> <br /> Please provide the following information: <br /> <br />I. Name of Applicant: <br /> <br />2. Address of Applicant: <br /> <br />3. Contact Person for Applicant: <br /> <br />4. Telephone Number of #3: <br /> <br />5. Proposed Radio Band (if known): <br /> <br />6. Proposed Radio Frequency(s) (if known): <br /> <br />7. Technical Advisor (if any): <br /> Provide the following technical data if it has been determined: <br /> Proposed Base Station(s): Mfg: <br /> <br /> I0. <br /> <br />I1. <br /> <br />I2 <br /> <br />I3. <br /> <br />Model: <br /> <br />Power Output: <br /> <br />Antenna Type: <br /> <br />Mfg. and Model of Isolator: <br /> <br />Mfg. and Model of Duplexer: <br /> <br />Mfg. and Model of Filters: <br /> <br />Date proposed for operation: <br /> <br />Describe space and AC power requirements: <br /> <br />14. <br /> <br />15. <br /> <br />Signature: Date: <br /> <br />After all available information has been included above, mail the application form and an <br />engineering fee of $300, payable to the City of Ramsey, for each channel to: <br />City Engineer, City of Ramsey, 15153 Nowthen Boulevard NW, Ramsey, MN 55303 <br /> <br />NOTE:The engineering fee (which will not be returned) will be used to pay for an engineering <br /> analysis of the proposed frequency and equipment. When the analysis is completed, the <br /> applicant will be advised of the results and suitability of the proposed installation. A <br /> copy of the minimum technical standards for the Water Tower site is enclosed. <br /> <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />