FAYETTE COUNTY
ADMINISTRATIVE APPLICATION REQUEST
FOR COMMUNICATIONS TOWER USE
Project Name & Location:
Applicant/Agent:
Name and Company:
Contact Phone #: E-mail:
Property Owner(s) of Parent Tract:
Names of all owners on latest recorded Warranty Deed:
Mailing Address:
Owner Phone #:
E-mail:
Tower Company:
Name of Representative and Company:
Mailing Address:
Phone #: E-mail:
Project Locational Information:
Project site address:
Land District #: Land Lot #: Parcel #:
Acreage of parent tract: Zoning District:
Road frontage(s):
Proposed Tower Information:
Type of tower proposed:
Tower height (from grade to highest point):
Type of accessory facilities:
Total square feet proposed:
Applicant
=
s Notarized Certification:
I affirm and certify that I understand and will comply with the provisions and regulations of the Fayette County Zoning
Ordinance. I further certify that all the information contained in this application and all documentation submitted herewith is
true to the best of my knowledge and belief. Further, I understand that the application, attachments and fees become a part of the
Official Records of the Fayette County Planning & Zoning Department and are not returnable.
Signature of Applicant/Agent Date
Signature/Stamp of Notary Public Date
PROPERTY OWNER CONSENT AND AGENT AUTHORIZATION FORM
(Applications require authorization by ALL property owners of subject property).
I/We hereby certify that I/We are the current property owner(s) of record of the parent parcel on which the
requested communications tower use will be located. Further, I/We authorize the following as my Agent
of
Name of Representative Name of Company
to act on my behalf to seek approvals from Fayette County for the requested communications tower to be
located on my/our property. I/We understand that this application, attachments and fees become part of
the official records of the Planning & Zoning Department of Fayette County. I/We have reviewed the
completed application and the statements or showings made in any paper or plans submitted herewith are
true to the best of my/our knowledge and belief. I/We understand that any knowingly false information
given will result in the denial of this application request. I/We further acknowledge that additional
information may be required by Fayette County in order to process this application.
Name(s) of All Property Owners of Record found on latest recorded Warranty Deed for subject property:
Please Print Names
___________________________________ ____________________________________
Signature of Property Owner 1 Signature of Notary Public
___________________________________ ____________________________________
Address Date
___________________________________ ____________________________________
Signature of Property Owner 2 Signature of Notary Public
___________________________________ ____________________________________
Address Date
___________________________________ ____________________________________
Signature of Property Owner 3 Signature of Notary Public
___________________________________ ____________________________________
Address Date
__________________________________ ____________________________________
Signature of Authorized Agent Signature of Notary Public
___________________________________ ____________________________________
Address Date
FAYETTE COUNTY PLANNING & ZONING DEPT.
COMMUNICATION TOWERS CHECKLIST
FOR ADMINISTRATIVE APPLICATION SUBMITTAL
ALL OF THE FOLLOWING ITEMS ARE REQUIRED FOR APPLICATION SUBMITTAL
FOR NEW COMMUNICATIONS TOWERS. ANY DEFICIENCIES WILL BE NOTED WITH
A * BELOW.
_____ Completed application forms signed and notarized;
_____ Proof of ownership of the parent tract (latest recorded deed);
_____ Site plan prepared by an engineer, architect, or landscape architect registered by the state;
_____ Landscape plans;
_____ Provide number of carriers based on maximum height of tower; and
_____ A lease agreement with a minimum of one carrier.
Site Plan Requirements. All tower applicants for new towers shall be required to submit a scaled site
plan which complies with all applicable requirements of chapter 104, development regulations.
Additional information indicated on the site plan shall include:
_____ A signed/sealed survey by a land surveyor registered in the state of the parent tract, leased area,
and ingress/egress easement, indicating the metes and bounds for each;
_____ Total tower height including antennas;
_____ Type and design of any tower facility, including location of equipment buildings or cabinets;
_____ Distance from nearest off-site residences;
_____ Fencing and gate details;
_____ All applicable setbacks for the tower, tower facility, and anchors for guyed tower, as applicable;
_____ Distance from existing and planned towers;
_____ Distance from all adjacent municipalities and counties;
_____ Zoning and acreage of parent tract;
_____ Zoning of adjacent property; and
_____ Other information necessary to assess compliance with this chapter.
STAFF COMMENTS:
APPLICATION SUFFICIENT AND ACCEPTED:
ZONING ADMINISTRATOR DATE
APPLICATION INSUFFICIENT - RESUBMIT
ZONING ADMINISTRATOR DATE