Fillable SMALL CELL RIGHT OF WAY UTILIZATION APPLICATION (City of Midland Texas)

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SMALL CELL RIGHT OF WAY UTILIZATION APPLICATION (City of Midland Texas)

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The SMALL CELL RIGHT OF WAY UTILIZATION APPLICATION (City of Midland Texas) form is 1 page long and contains:

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File type: PDF

U.S.A. forms for City of Midland Texas

BROWSE CITY OF MIDLAND TEXAS (TX) FORMS

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SMALL CELL RIGHT OF WAY UTILIZATION APPLICATION
Date Submitted
Submitted By
APPLICANT INFORMATION
Company
Permit Name :
Address
City
Zip Code
Applicant
Contact
Phone
Number
Email
SITE INFORMATION
Legal Description of
Nearest
Property
Latitude
Longitude
Address (nearest cross
streets)
Closest Utility or
Network
Pole
Width
of ROW
Nearest Reside. Property
Ht. of existing poles
within
500 ft.
PROJECT DESCRIPTION (Attach Plans)
Pole Type
:
□
New Pole
□
Existing Pole
|
Number of nodes: _____________________
Est. Cost of Work
PERMIT ISSUANCE
Permit Number
Permit Name
Permit Fee
Permit Fee Status
□
Paid
□
Payment Pending
Approved by :______________________________________ Date:____________________________
Policies and Procedures
The following permit is valid for 180 days (6 months) from the printed date.
Traffic plans are approved separately. The contractor that will be physically responsible for the traffic control on site must contact
Troy Clabaugh at tclabaugh@midlandtexas.gov
to submit the proposed work dates and 24-hour contact information.
If you are requesting a 911 address, please contact the Planning Division at planningdept@midlandtexas.gov and provide the
coordinates along with a site plan/location map of the small cell tower.
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SMALL CELL RIGHT OF WAY UTILIZATION APPLICATION (City of Midland Texas)

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Completed 23 January 2021

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