9610 19TH AVE SE NEXTEL ANTENNA 2018-01-02 MF Import

Form Aooroved OMB No, 2120-0001 Please Tvoe or Prof on ) ins Form AeronauhplSts4y Number Notice of Proposed Construction or Alteration ^. Iti I f j us Ceoanrront dr Lansmnanon Failure ro Provide All Requested Information May Delay Processing O/ Your Notiye 'AriN' 1 �,J L (• Federal Aviation Admallsts 1. Nature of Pro osal 2. Complete Description of Structure A Tim B Class C. Work Schedule Dates Please describe the proposed construction or alteration. cut Pemanent Beglonmg I Z��GB A. For proposals involving transmating stations, include End (/G rj effective radiated povver (ERP) and assigned frequency. if Construction nal known,g frequency Temporary ( months) not _ mogive fre band and maximum ERP 7. cy Alteration a B. For proposals imolvirg overhead acre. Vansmssan lines. a f Alletation. provide previous FAA Aemnauliral Study Number, if Available: etc., include the size and the confguntion of the villas and 3A. Name, address, and telephone rrlmber of individual, company corporation, etc. proposing the their supporting structures. construction or alteration. (Number, Street, City, State, and Zip Code) C. For buildings. include site orientation, dimensions. and `, II t construction materials. Tr2 C0MI.A p 2SL L. t G . D. optional - Doscribe the type of obstruction marking and 1./v)LLrrL� j?. . �3E�'�'?"LE. �%� lightingsystemdesired. The FAAvitllconslderthisintheu 7 4ea- 34x e `�81 G study. Area Code Tele hone Number _ 3B. Name, address. and telephone number of proporlent's representative. d different than 3A. above. �uULI �7 `t-r , , .r-A ) . Tt�irws �t-tu�f� - s�nE .as �iL�7Jl�1�' L� �7 r l - W)o 0-I f 1 �I� �IIf•� Area Code Telephone Number 4. Location Of Structure 5. Hei hand Elevation dnearesro n (to nunmecPs of semnd" e. Nearest City or Tessin C. Nearest public. military all oil, A. Elevation of ground above mean A. Coordinates ,Iino..ns and State heliport eighipark, or ay(a�e base sea level. 1 lab e o b � r re G E3ZL—� all c (Jc�/ � %G on nude o 1 r u (1). Distance 10 4B 1 . Distance [ram structure to nearest B. Heght o/ strudvr0 including all point of nearest rurrvray appurtenances and lighting above round or waler 40, Source for rem 4A data. USGS 7.5- Survey ® Other (2). Direction Io 4B (2). Dun from structure tp aEiiryon C. Overall height above mean sea level Quad Chan iled specs C,:o, 721ZD IndiGte me reference datum GREW 4E. Description of site location with res ct to highways, street, air S, Prominent terrain, features, NAD 27 NAD 83 ❑ Other existing structures, etc. Please attach a U.S. Geological Survey Map (or equivalent) shovnrg the construction Specify site. N available, attach a copy of a documented site survey with the surveyoi s certirlption. Nct,cenreduced PYPan 17illew Federal AvuPnn Repuuo 77 are C Fle Pant >I PursuanttoSMon Itoi at me Federal.w..we Adolf 195a, as amended lagUS f aC 5'�II bond 3vno knp..n^,ryand ded(4vltSC me NPdceredueersn4of Pan ]T(cmnaltoaPne pnw dtt000 Per dryunelmeeducennot mi pursuant tor Secrrdn9e1(aloffe Feder al Avant Actof t 95a as amended (fie U S.C. aPP. S 1471 IaI)iFvree is me line (CnmNl penartY)df net more INn S'n0 for me lust offense and not rttlre man 52,00010r suUSCauent Orten5el. Pursuant m Stilton 9CFa', of •ne Xederal Arundn Ad d 195E as amended f4B U S C aoo tal2be I HEREBY CERTIFY that all of the above statements made by me are true, complete, and correct to the best of my knowledge. In addition, I agree to obstruction mark and/or light the structure in accordance with established marking& li htin standards asneeessa ]a.e iyPedor Printed Name and Tile of Person Fnng r,orce Signature }�\ FOR FAA USEON The o 0& L 7 oc a :n'�dYA�1171 [J so Ill. - eefluivPYee mbegy- ❑ OC!en1C9Pn IIINkFIp h171g'eb[ •-.NMAfm�Yfe the Rerarq -•rEy. _ .. nt�R` _.-...•-. ,--.. _ wotdrinw Nr►^y-'alCff� i NAD$_3 CoOfdlna='"!l"'tr ._ alit e _ . an itude - sg�at.�e i ate v „4_ I✓�� /s ?� NSN: 0052-00-012-0007 FAA Farm 746G-1 ("4) SuPersedes Previous Ed4uns