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2. Small Cell Ordinance
   For more information on the Small Cell Ordinance, click here.
4. Applicant’s Name:*
6. Address:*
8. City:*
9. State:*
10. Zip Code:*
12. Phone Number:*
13. Email Address:
15. Facility Owner’s Name:
17. Address:
19. City:
20. State:
21. Zip Code:
23. Phone Number:
24. Email Address:
26. Intended facility use: owner operated or owner leased capacity*
28. The names, addresses, telephone numbers, and e-mail addresses of all consultants, if any, acting on behalf of the Applicant with respect to the filing of the Application:
30. A general description of the proposed scope of work for the Collocation of the Small Wireless Facility:*
    The scope and detail of such description shall be appropriate to the nature and character of the work to be performed, with special emphasis on those matters, including but not limited to sub-surface utilities, likely to be affected or impacted by the work proposed.
32. Identification of any consultant that is acting on behalf of the Applicant and that is authorized to speak with the City, or a designee of the City, on the area of consultation for the Applicant even if the Applicant cannot be available:
34. Identification:
35. Verification from an appropriate representative of the Applicant that the Small Wireless Facility shall comply with all Applicable Codes:
37. Verification of payment of the annual municipal consent or administrative fee for telecommunications companies to use Public Rights-of-Ways pursuant to Section 58-9-2230:
38. Verification of local business license:
40. Evidence the Applicant is duly authorized to do business in South Carolina:
41. Evidence the Applicant has received any necessary certificate of public convenience and necessity or other required authority from the South Carolina Public Service Commission or the Federal Communications Commission or evidence that it is not required:
43. A copy of an approved South Carolina Department of Transportation encroachment permit and all documents required by SCDOT as part of the encroachment permit application, if the proposed location is within a SCDOT Right-of-Way:
44. If the proposed location is outside of a SCDOT Right-of-Way, a statement that the Applicant has a lease, attachment agreement or other authorization from the owner of the Utility Pole or structure proposed for Collocation:
46. Application Fees:
    Unless otherwise provided by law, and except as to telecommunication companies exempted pursuant to S.C. Code § 58-9-2230, all Applications for permits pursuant to this Ordinance shall be accompanied by a Fee of $100.00 for each Small Wireless Facility, except that the Fee for Small Wireless Facilities addressed in a consolidated Application shall be $100.00 each for the first five Small Wireless Facilities and $50.00 for each additional Small Wireless Facility up to a maximum of twenty (20) Small Wireless Facilities. For clarity, any Applicant that pays either a franchise, consent Fee, or administrative Fee pursuant to the requirements of S.C. Code § 58-9-2230 shall not be required to pay any building permit Fee, zoning permit Fee, encroachment Fee, degradation Fee, or any other Fee assessed on a telecommunications provider for its occupation of or work within the ROW.
48. Application Fee
    each for the first five Small Wireless Facility
49. Price
50. Quantity
51. Shipping Cost
53. Taxable
55. Application Fee
    $50.00 for each additional Small Wireless Facility up to a maximum of twenty (20)
56. Price
57. Quantity
58. Shipping Cost
60. Taxable
62. I understand the Small Cell Ordinance as posted.*

    1. yes

    https://www.summervillesc.gov/DocumentCenter/View/2173/Small-Cell-Ordinance-PDF
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