Site License Application
Please fill out the form below with desired colocation information. This application will determine the loading for the corresponding structural analysis. Hit submit when complete and we will be in contact shortly.
Site Information
Site Concepts Site Name
Customer Site Name
Street Address, City, State, Zip
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Latitude/Longitude
Latitude
Longitude
Application Submission Date | Proposed On Air/Change Out Date:
Application Submission Date:
Proposed On Air/Change Out Date:
Customer Contact Information
Name
Title
Telephone
Email
Address
Applicant Contact Information
Real Estate Manager
RF Engineer Manager
Construction Manager
Site Acquisition Manager
Emergency Contact
Accounts Payable Contact
Signatory Information
Other
Billing Information
#1
Licensed Entity Name
State of Incorporation
Notification Address
Billing Address
Antenna Space and Equipment
Existing/Leased Antenna Configuration Sector 1
Existing/Leased Antenna Configuration Sector 2
Existing/Leased Antenna Configuration Sector 3
Proposed Final Antenna Configuration
Sector 1
Proposed Final Antenna Configuration
Sector 2
Proposed Final Antenna Configuration
Sector 3
Status (Leased/Existing/Proposed/)
RAD Center AGL
Antenna Mount Height
Antenna Quantity
Antenna Manufacturer
Antenna Type (Panel, Omni, etc.)
Antenna Model #
Antenna Dimensions (indicate inches-H" x W" x D")
Antenna Weight (per antenna in LB's)
Direction of Radiation (Azimuth)
TX Frequency
RX Frequency
TMA Quantity
TMA Manufacturer & Model
TMA Dimensions
TMA Weight
Diplexer Quantity
Diplexer Manufacturer & Model
Diplexer Dimensions
Diplexer Weight
RRU Quantity
RRU Manufacturer & Model
RRU Dimensions
RRU Weight
Other Equipment Quantity
Other Equipment Manufacturer & Model
Other Equipment Dimensions
Other Equipment Weight
# of Coax Cables Per Sector
Diameter of Coax Cables
# of Fiber Cables Per Sector
Diameter of Fiber Cables
# of Hybrid Cables Per Sector
Diameter of Hybrid Cables
# of RET Cables Per Sector
Diameter of RET Cables
Receive or Transmit
TX Frequency
RX Frequency
Type of Service (LTE, CDMA, GSM, Broadcast, etc.)
Mounts
Existing/Leased Antenna Configuration
Sector 1
Existing/Leased Antenna Configuration
Sector 2
Existing/Leased Antenna Configuration
Sector 3
Proposed Final Antenna Configuration
Sector 1
Proposed Final Antenna Configuration
Sector 2
Proposed Final Antenna Configuration
Sector 3
Mount Analysis Requested (Y/N)
Mount Specs/As Builts in Possession (Y/N)
Mount Analysis Requested w/ Tower Climb
Microwave Space and Equipment
Existing/Leased Antenna Configuration
Sector 1
Existing/Leased Antenna Configuration
Sector 2
Existing/Leased Antenna Configuration
Sector 3
Proposed Final Antenna Configuration
Sector 1
Proposed Final Antenna Configuration
Sector 2
Proposed Final Antenna Configuration
Sector 3
Status (Leased/Existing/Proposed/)
MW RAD Center AGL
MW Mount Height
MW Quantity
MW Manufacturer
MW Model #
MW Dimensions (indicate inches-H" x W" x D")
MW Weight (per unit in LB's)
MW Direction of Radiation (Azimuth)
ODU Quantity
ODU Manufacturer & Model
ODU Dimensions
ODU Weight
# of Coax Cables Per MW
Diameter of Coax Cables
# of Fiber Cables Per MW
Diameter of Fiber Cables
TX Frequency
RX Frequency
Brief Description of Work to be Performed
Building/Shelter Space and Equipment
Existing/Leased Space and Equipment
Proposed Space and Equipment
Status (existing/proposed)
Type of Enclosure (shelter, cabinets, etc.)
Leased Ground Space Dimensions (W'x L'x H')
Concrete Pad Dimensions (W'x L'x H')
Shelter/Cabinet Dimensions (W'x L'x H')
Shelter/Cabinet Manufacturer/Model/Quantity
Generator Leased Ground Dimensions (W'x L'x H')
Generator Make & Model
Generator Fuel Type
Generator Fuel Tank Ground Dimensions (W'x L'x H')
Fuel Tank Type (above ground, underground, integrated w/ generator)
Fuel Tank Location
Fuel Tank Capacity (gallons)
Telco/Interconnect Requirements
Base Station Equipment Manufacturer
Type and Model
Type of Service
Average Monthly Power Consumption (kw)
Electric Service Required (Amps/Volts)
Batteries to be Installed within Ground Lease Area
Quantity & Type Batteries (lead acid, dry cell)
For Site Concepts Use - Account Manager
#1
#2
#3
#4
#5
Lease Type (MLA, SLA, AMD, REW)
Application Fee: ($0 initial, $1500per re-submit)
Monthly Lease Rate:
Monthly Amendment Increase Rate:
Commencement Date:
Annual Escalator:
Initial Term:
Renewal Term:
Tower Portfolio:
Same Store:
Organic/In-Organic
Tenant Type:
Drafting Instructions:
For Site Concepts Use - Operations
#1
#2
#3
#4
#5
Structural Analysis / Yes - $2000
Tower Mapping Exists (Y/N)
RF Study (SSIS)
LL Consent
Notice of LL
ROFR
Rev Share
Approval Conditions
Date
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Colocation Specialist Approval:
Submit
Should be Empty: