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Name
Address
City
State / zip
Phone
Email
Site Name
Site Address
City	State    Zip
County	Country  Foreign Zip Code
Foundation Type	PIER FOUNDATION  MATT FOUNDATION  Yes / No
Ice	THICKNESS  ICE   Yes / No
Wind Speed	MPH     3 sec. gust.  Yes / No
Tower Height	Type of antenna Mounts
Revision	Revision F            Yes / No        Revision G             Yes / No
Special  -
Request
Lighting Kit	Yes / No  Lighting required if tower extends beyond 199'
	Antenna Model @ Size
	Quantity   Height on Tower
	Quantity   Height on Tower
	Quantity   Height on Tower
	Quantity   Height on Tower
	Quantity   Height on Tower
	Quantity   Height on Tower
	Quantity   Height on Tower
	(1) Bottom Ports: 3' @ 0°     EXIT PORT LAYOUTS	Yes / No
	(2)Bottom Ports: 3' @ 180°	Yes / No
	(3) Bottom Ports: (2ea) 3' 0°/180°  and (1) @ 8' 90°	Yes / No
	(4) Bottom Ports: (2ea) 3' 0°/180°  and (2) @ 8'	Yes / No
	(5) Bottom Ports: (2ea) 3' 0°/180°, (2) @ 9" 90°/270° and (1) @ 6" 0°	Yes / No
	(6) Bottom Ports:  (2ea) 3' 0°/180°, (2) @ 9" 90°/270° and (1) @ 6" 0°/180°	Yes / No
	Call if you need assistance we have someone to answer your questions 7 days a week,    360-474-8991

GEOTECH REPORTS WILL NEED TO BE RECEIVED TO PERFORM FOUNDATION DRAWINGS