Application: Wireless Services

A PDF version of this form can be found here: Wireless Services Tech Form

Property Owner Details

Name of Property Owner(Required)

First Last

Company Name(Required)

Contact Information of Property Owner(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone Number of Property Owner(Required)

Email of Property Owner(Required)

Applicant Details

Name of Applicant(Required)

First Last

Company Name(Required)

Contact Information of Applicant(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone Number of Applicant(Required)

Email of Applicant(Required)

Application Checkist

Wireless telecommunication services facilities are permitted only in the I (industrial) zoning district.

Application Fee: Check # and Amount $

Poudre Fire Authority Development Review Fee

Site Plans

One or more plats or maps, scale not less that 1″ = 50′, showing the following information:

Proposed size, location and boundaries
Existing and proposed topography at 2 ft. intervals, referenced to USGS data
Plane coordinates and a legal description of the proposed site
Elevations of all towers and equipment, indicating materials, exterior dimensions and colors
True north arrow
Locations and size of existing improvements, existing vegetation, if any
Location and size of proposed improvements, including any landscaping
Existing utility easements and other rights-of-way of record, if any
Location of access roads
Names of abutting subdivisions or owners of abutting, unplatted property within 400 ft.
Zoning and uses of adjacent parcels
Proof of ownership
Location of the GPS in both latitude/longitude and UTM meters

Vicinity Maps

Include one or more maps showing the location of existing and planned commercial mobile radio service facilities belonging to the applicant, within 5 miles of the facility

Written Narrative

Applicant’s and surface owner’s names, addresses, signatures and designation of agent
Explanation of the need for such a facility, operating plan and coverage area
If a freestanding facility, analysis of alternatives to a freestanding facility within a 1-mile radius
List of all permits or approvals obtained/to be obtained from all agencies other than the Federal Communications Commission (FCC)
Affirmation that the proposed facility, alone or in combination with other like facilities, will comply with current FCC standards
Affirmation that the facility will comply at all times with current FCC interference regulations
Affirmation that the facility will not interfere with any public safety frequencies
Affirmation that, if approved, the applicant and surface owner will make the facility available, on a reasonable basis, to other service providers
An explanation of compatibility with the Town Comprehensive Plan

Upload All Required Documents(Required)

Drop files here or

Max. file size: 20 MB, Max. files: 20.

Consent

*The Town and Applicant agree to conduct transactions related to submission and review of this application by electronic means, pursuant to the Uniform Transactions Act, Sec. 24-71.3-101, et seq., C.R.S. The Town or the Applicant may refuse to conduct other transactions by electronic means. If the Applicant does not agree to submit the application by electronic means, a physical paper application may be filed with the Town at 4750 Signal Tree Drive, Timnath, CO 80547.

Signature(Required)

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