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February 2012 CITY OF EVANSTON 1200 Main Street, Evanston, Wyoming 82930 Ph.# (307) 783-6470 Fax: (307) 783-6490 Web: www.evanstonwy.org Wireless Communication Tower Application $1000.00 + building permit as applicable (Colocation requires a building permit only) Zoning: Location: Legal Description: Reason for request: Name of applicant: Mailing address: Phone number: Name of property owner (if applicant is NOT the property owner): Mailing address: Phone number: Signature of applicant: - - - - - - - - - - - - - - - - - - - BELOW FOR OFFICE USE ONLY - - - - - - - - - - - - - - - - - - - - Date filed: Hearing date: Case Receipt Planning Department Action: Approved Denied Tabled Withdrawn Stipulations Stipulations: Date: Signature of Planning Secretary I wish to appeal to the Planning and Zoning Commission Signature: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Planning and Zoning Commission/Board of Adjustment Action: Approved Denied Tabled Withdrawn Stipulations Stipulations: Date: Signature of Planning and Zoning Secretary I wish to appeal to City Council Signature: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - City Council Action: Approved Denied Tabled Withdrawn Stipulations Stipulations: