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<br />SMEU Fonn 346 <br /> <br />A P P L I CAT ION <br />FOR POL E <br /> <br />AND PER M I T <br />CON T ACT S <br /> <br />Application <br />and Pennit No. <br />(Number to be assigned by SMEU)- <br /> <br />Date <br /> <br />In accordance with and subject to all of the conditions of the General Agreement <br />dated ,,19 between <br />hereafter called Licensee" and <br />hereafter called Licensor" the Licensee hereby requests pennission to contact <br />poles and/or give notice of contact removal from poles ~ned by the Licensor <br />in and/or near the town of , Texas. <br />The locations of the poles to be contacted are shown on the attached sketch which <br />is a part of this application and penn,it. <br /> <br />POL E <br /> <br />A T T A C H MEN T 5 <br /> <br />Balance prior to this application <br /> <br />Add for this pennit <br />Removed for thi s penDi t <br /> <br />New Balance <br /> <br />RECOMMENDED: <br /> <br />Licensee: <br /> <br />By: <br /> <br />Title: <br />Pennission is hereby granted the Licensee for this application. <br /> <br />RECOMMENDED: <br /> <br />Date <br /> <br />Licensor: <br /> <br />By: <br /> <br />Title: <br /> <br />(This Fonn Must Be Prepared in Duplicate) <br />