COLLOCATION APPLICATION

New Lease Amendment


NCN SITE INFORMATION







CARRIER INFORMATION

















FREQUENCY INFORMATION




Yes


Yes







GROUND/ROOFTOP/INTERIOR LEASED RIGHTS




Yes


Yes


Yes











Yes


Yes





EQUIPMENT LEASED RIGHTS

Type Qty Location or Height Mount Manufacturer Model Weight Dimensions Azimuth

CABLE/FIBER/COAX LEASED RIGHTS

Type Qty Size Length Fiber

GENERAL SCOPE OF WORK, SPECIAL CONSIDERATIONS AND COMMENTS