FCC LICENSE APPLICATION SITE QUESTIONNAIRE

FCC LICENSE APPLICATION SITE QUESTIONNAIRE

(Provide this information for each SITE)
SITE INFORMATION
1) Your Company Name: *
Your Company Name
2) Site Name: *
Site Name
3) FCC Antenna Structure Registration (ASR) Number (if ASR is not available please fill out the Antenna Support Structure Information and FAA Information below) *
ASR
4) Address or Description of Location (Example: Off Hwy 224 on top of Goat Mountain) *

Street Address Line 1

Street Address Line 2
5) City, State, Zip Code *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
ANTENNA SUPPORT STRUCTURE INFORMATION

(Complete this section only if ASR number is NOT provided in Question 2 above)
6) Type of Antenna Support Structure. (Tower, Building, Monopole) *
7) Height of Antenna Support Structure WITHOUT Accessory Objects. (Appurtenances) *
8) Height of Antenna Support Structure WITH Accessory Objects. (Appurtenances) *
FAA INFORMATION REQUIRED BY FCC

(Complete this section only if ASR number is NOT provided in Question 2 above and Antenna Support Structure is NOT a building)
9) Has a Notification been filed with the FAA for the structure? *

YES NO
10) Has a "DETERMINATION OF NO HAZARD TO AIR NAVIGATION" letter been received from the FAA? *

YES NO
11) FAA Aeronautical Study Number *
12) Tower Owner *
Trango Networks, LLC.
400 Ternes Drive
Random Lake, WI 53075 USA

Tel: +1 (858) 391-0010

Fax: +1 (920) 994-9990

https://gotrango.com
Should be Empty:

SITE INFORMATION