Laserfiche WebLink
Appendix C <br />San Marcos Electric Utility <br />APPLICATION AND PERMIT <br />FOR POLE CONTACTS <br />Form PCI -2004 <br />Application Date: Permit No. <br />To: San Marcos Electric Utility <br />630 E. Hopkins Street <br />San Marcos, Texas 78666 <br />_Desire to Attach to Poles <br />Desire to Vacate Poles <br />Narrative Description of proposed activity: <br />In accordance with the terms and condition of the License Agreement Date , <br />application is hereby made for a permit to occupy /and or vacate the poles in the locations detailed on attached <br />Field Data Sheets and Map Designs and pursuant to the "Suggested Construction Standards and Design <br />Review Information." <br />All Cable contact locations to be determined by Utility. <br />POLE ATTACHMENTS <br />Balance prior to this application <br />Add for this permit <br />Removed for this permit <br />New Balance <br />Licensee <br />Contact Person <br />Title <br />Telephone No._ <br />Fax No. <br />Email <br />Signature <br />Permission is hereby granted to Licensee to attach and /or vacate poles listed on the attached Field Data Sheets, <br />subject to payment of the necessary Make -Ready Work charges attached. <br />Date <br />Utility: San Marcos Electric Utility <br />Approved By: Rumaldo Rodriguez <br />Title: Electrical Eng Tech Signature <br />Telephone No: 512- 393 -8335 <br />26 <br />C: \Documents and Settings \tamara.slade \Local Settings \Temporary Internet Files \Content.Outlook \F3JWG5DH \San Marcos <br />PAA_FINAL_CLEAN_10 17 201 Ldocx <br />