Partitioner Jonesboro_368-415_Communication Tower ApplicationCommunications Tower Ordinance of Harnett County
North Carolina Application Permit
Received: ___________________________________________ _______________
Harnett County Planning Department Date HCWFC-03
Date Submitted:_____________________________
APPLICANT’S NAME: ________________________________________________________________________________
Phone: _______________________ FAX: _____________________ E-mail: _____________________________
PROPERTY OWNER: _____________________________________________ Phone: ____________________________
APPLICANT'S CONTACT: ____________________________________________________________________________
Address:____________________________________________________________________________________
Phone: _______________________ FAX: _____________________ E-mail: _____________________________
Lessor/Licensor Contact Information:
Name: ______________________________________________________________________________________
Address: ___________________________________________________________________________________
Phone: _______________________ FAX: ______________________E-mail: ____________________________
Commercial Wireless Provider:_______________________________________________________________
New Structure: Yes [ ] No [ ] Co-location: Yes [ ] No [ ] Water Tower: Yes [ ] No [ ]
Replace Existing Structure: Yes [ ] No [ ] Replacement (upgrade) of Existing Antennas: Yes [ ] No [ ]
Stealth Attached Facility: Yes [ ] No [ ] New Stealth Antenna Support Structure: Yes [ ] No [ ]
FACILITY INFORMATION:
Site Address:_______________________________________________________________________________________
Latitude (NAD83): _________________________________Longitude (NAD83): _________________________________
Ground Elevation (AMSL) (ft): _______________________Total Height of Tower: (AGL) (ft)_______________________
RAD Center (ft): _____________________________________________________________________________________
TAX Parcel Identification Number: _____________________________________________________________________
Present Zoning of Property: __________________________________________________________________________
Land Use and Description of Property: _________________________________________________________________
FCC Antenna Structure Registration Number (ASR) (if applicable): __________________________________________
The following must be enclosed with this application:
1. A map (electronic preferable) of the same search ring submitted and used by the applicant’s site locator;
2. A map (electronic preferable) indicating applicant’s existing RF signal propagation;
3. A map (electronic preferable) indicating proposed new RF signal propagation;
4. A statement (electronic preferable) from a qualified individual that the applicant will comply with all FCC
rules regarding human exposure to RF energy, along with the individual’s qualifications.
5. A statement (electronic preferable) from the applicant that the applicant will comply with all applicable FCC
rules regarding radio-frequency interference;
6. A statement (electronic preferable) that the submitted search ring is the same as utilized in the selection of
the sit;
7. Complete plans of the proposed facility to include a structural certification by a Registered Professional
Engineer that the facility complies with applicable Harnett County building codes; to include, if necessary,
required structural modifications;
8. A completed “County of Harnett Land Use Application” and Application Fee
Communications Tower Ordinance of Harnett County
North Carolina Application Permit
Received: ___________________________________________ _______________
Harnett County Planning Department Date HCWFC-03
Please Note: Supplemental information may be requested for purposes of clarity or confirmation.