Administrative Wireless Permit Application

Project Information

Name of Project:

Tax Parcel Number(s):

Site Address:

Wireless Communication Facility to be Amended or Proposed:

Tower

Antenna

Applicant

Phone Number

Property Information

Zoning:

Land Use Designation:

Total Acres:

Current Use:

Property Owner if other than Applicant:

Notices:

1. Procedure: The procedures for this permit are outlined in the Bonney Lake Municipal Code 14.30.020.

2. Completeness: You application will be deemed complete 29 days after submittal, unless otherwise notified.

3. Ownership: The Owner of the property as identified on the Pierce County Tax Assessor’s website must either sign this application form or submit a notarized letter stating that the Applicant and/or Project Contact to act as the Owners agent regarding the property at the above-referenced address for the purpose of filing land use applications and have full power and authority to perform on behalf of the Owner all acts required to enable the City to process and review such applications. If the property was recently purchased and sale is not reflected on the Pierce County Assessor’s website, the new Owner must submit documentation demonstrating that he/she has purchased the property. Alternatively, a copy of a lease agreement may be submitted.

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Certification

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I certify that the information on this application is true and correct and that the applicable requirements have been met. I also certify that I have read and understand the notices related to Procedure, Ownership and Completeness.