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Item 26 - Approve Municipal Facilities License Agreement with T-Mobile West LLC
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11/07/2023 Regular
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Item 26 - Approve Municipal Facilities License Agreement with T-Mobile West LLC
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11/1/2023 2:13:03 PM
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11/1/2023 1:42:53 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
26
Date
11/7/2023
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B-1 <br />EXHIBIT B <br /> <br />APPLICATION TO USE MUNICIPAL FACILITY <br /> <br /> <br />Applicant: ___________________________Date: ______________________________ <br />Licensee:____________________________Application/License#:__________________ <br /> <br />Type of <br />Municipal <br />Facility <br />Alteration <br />Required <br />Small Cell Equipment <br />Heights (provide both (1) the <br />overall height of pole structure <br />with added facilities; and (2) <br />the height of individual <br />facilities) <br />Small Cell <br />and Base <br />Equipment <br />Weights <br />Small Cell <br />And Base <br />Equipment <br />Dimensions <br />Location of Any <br />Additional Equipment <br />Street Light None [Installed on Pole, specify <br />attachment height, weight <br />and dimensions] <br />[Installed on/in Ground <br />(Vault), specific <br />dimensions] <br />[Other Location] <br />[Not Applicable/Needed] <br /> <br /> <br />APPLICANT SHALL PROVIDE THE FOLLOWING AS APPLICABLE: <br />• Site plan and engineering design and specifications for installation of Equipment, including <br />the location of radios, antenna facilities, transmitters, equipment shelters, cables, conduit, <br />point of demarcation, backhaul solution, electrical distribution panel, electric meter, and <br />electrical conduit and cabling. Where applicable, the design documents should include <br />specifications on design, pole modification, and ADA compliance. Also indicate whether <br />unmetered electricity is available at the site. <br />• Include a load bearing study that determines whether the pole requires reinforcement or <br />replacement in order to accommodate attachment of proposed Equipment. <br />• If the proposed installation will require reinforcement or replacement of an existing pole, <br />provide applicable design and specification drawings. <br />• The number, size, type and proximity to the facilities of all communications conduit(s) and <br />cables to be installed. <br />• Description of the utility services required to support the facilities to be installed. <br />• List of the contractors and subcontractors, and their contact information, authorized to work on <br />the project. <br />• A check for the applicable Application Fee made payable to the City of Santa Ana (refer to <br />Section 5.1 of the Municipal Facilities License Agreement). <br />APPLICANT SIGNATURE: __________________________________ <br />PRINT NAME: _____________________________________________ <br />TITLE: ____________________________________________________ <br />DocuSign Envelope ID: C2BC4D90-5342-462C-B1AB-E6E0C7461A47
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