Name
	Address
	City
	State / zip
	Phone
	Email
	Site Name
	City
	County
	State 2
	Engineered Drawings	Yes / No  PE/WET STAMPED
	Foundation Drawings	Yes / No
	Foundation Type	Yes / No  PIER FOUNDATION?   Yes / No  MATT FOUNDATION?
	Wind Speed	WILL ANY RADIAL ICE OCCUR  Yes / No
	Maximum Wind Sped	MPH     3 sec. gust.  CONTACT YOUR LOCAL BUILDING PERMIT OFFICE..
	Tower Type	Self-Support   Yes / No     Guyed Yes / No
	Tower Height
	Lighting Kit	Yes / No  Lighting required if tower extends beyond 199'
	Antenna Model  SIZE	Quantity        Height on Tower
	Antenna Model  SIZE	Quantity        Height on Tower