Simple Cell Permit Management Application

Property Owner Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Property Owner Email

example@example.com

Property Owner Phone Number

Area CodePhone Number

Property Owner Name

First NameLast Name

Applicant Name (if different than owner)

First NameLast Name

Applicant Address (if different than owner)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Applicant Phone Number (if different than owner)

Area CodePhone Number

Applicant Email (if different than owner)

example@example.com

Name of Jurisdiction (County / Town / City)

Type of Application (select all that apply)

If "New Tower" is selected above, how close is the nearest tower? If less than 2 miles, please explain why it is needed.

Tower Location / Address

FAA Study Number (if applicable)

Antenna Structure Registration Number (if applicable)

Scope of Work

Latitude / Longitude of Centerline Tower

General Contractor

State Contractor’s License Number

Contractor’s City Business License Number (if applicable)

Estimated Construction Dates

Fee Schedule

The fee for a cellular antenna tower is $1600 per tower. Please remit a check in the amount of $1000 to Simple Cell Permit Management and send to the following mailing address:

Simple Cell Permit Management
251 Ridge Road
Shelby, AL 35143

This application may be mailed with the check or emailed to simplecellpm@outlook.com

Also, please mail a check to the jurisdiction in the amount of $600 for the application fee.

Signature (please type full name)

Required Documents

• Licensed Engineer Stamped Construction Drawings
• Passing Structural Analysis or Post-Mod Structural Analysis
• FAA Study Number (or reason why no study has been completed)
• Letter of Intent
• Current State IBC and NEC
• State Licensed Engineer Drawings
• Tower Owner Approved Construction Drawings
• 1A, 2C, FAA approved height
• Survey / Legal Description
• Antenna Structure Registration Number
• Time Stamped Photos of site to confirm no endangered species on site
• Redacted Lease Agreement
• General Contractor and Associated Licenses
- State Licensed GC
- Sub GC
- State Licensed EC (if required)

The above documents may be emailed to simplecellpm@outlook.com or mailed to the above mailing address. All documents will be reviewed and approved or rejected within 10 days of approved submittal request confirmation email.

Approved permits are null and void one year after approval date.