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4 <br /> TOWER DETAILS <br /> Applicant's Intended Purpose of Tower <br /> (e.g. coverage,capacity,other). Explain. Coverage <br /> Type of Tower(e.g. monopole,self-support lattice,guyed lattice,etc.) Monopol e <br /> Above Ground Level (AGL) Height (ft.) (i.e. maximum design 155 ' extendable to 190 ' <br /> potential). <br /> Base/Ground Elevation(ft.) 9 0 2 .3 <br /> What is the"fall-down radius"(ft.)of the proposed tower? N/A <br /> Technology to be Initially Sited on the Proposed Tower (e.g. <br /> Cellular,PCS,Radio,Television,Microwave,etc.)4 Cellular, AWS, PCS, LTE <br /> Number & elevation (Feet AGL) of 15 0 ' 16 0 ' 17 0 ' 18 5 ' <br /> Antenna Arrays to be Accommodated <br /> 1 2 3 4 _ 5 6 <br /> Is the primary sponsor of this tower If a wireless service Ve r i z on Wireless <br /> a wireless service provider or a Both provider,please include <br /> tower builder? FCC license number. KNLF-24 0 <br /> To the best of the applicant's Yes No If applicable,please explain in the box below to the <br /> knowledge,will this tower be _ _ greatest extent known in what manner the tower will be <br /> lighted? Circle One lighted. <br /> Lighting Configuration: <br /> Are there any mitigation measures being taken to minimize the visual impact of this tower? If so, explain. Attach <br /> an additional page if necessary. <br /> N/A per WI Stats Sec 66 . 0404 (4) (g) <br /> PRELIMINARY INFORMATION ON OPTIONS FOR COLLOCATION' <br /> What search area radius was used to determine the location of the proposed tower? . 5 miles <br /> Are there any existing towers or other potentially suitable structures in excess of 80 feet in <br /> height within a 1.5 mile radius? If yes, how many structures total are there? Yes No <br /> structures. If yes, please attach map showing the location of these structures in <br /> proximity to the proposed tower. N/A Per WI Stats 6 6 . 0 4 0 4 (4) (p) Circle One <br /> Has the applicant examined each of the structures noted above to determine if an antenna Yes No <br /> array can or may be located on the struc N�A per WI Stats 6 6 . 0 4 0 4 (4) (p) Circle One <br /> a Note that this statement in itself does not necessarily preclude in the future the placement of alternative <br /> technologies on this structure. <br /> 5 Note that more detailed information regarding options for collocation and addressing s. 10.194(2)of the <br /> Dane County Code of Ordinances is required in the Written Statement. <br /> H:\Zoning\Zoning Division Documentation\Informational Materials\Communication Towers\Communication Tower Application <br /> Packet 09-2010.doc <br /> Page 7 of 10 <br /> 210 Martin Luther King Jr.Blvd..Room 116,City-County Bldg.❖Madison,WI 53703-3342❖Phone:608.266.4266+Fax:608.267.1540 <br />