State road (name and number)

TxDOT District (name and number)

Network Provider's site name and/or identifier number (e.g., “Abilene - North,” “TX3449859”)

Full address of proposed Broadband Installation location (if none available, use the closest address to assist the reviewer in finding the site)

Historic or Design District name, if applicable

Latitude and longitude are expressed in degree/decimal format (e.g., XX.XXXXXX) to the NAD83 standard and accurate to ±1 meter.

Email and phone number for the applicant's engineer

Email and phone number for the applicant's single point of contact

5-square-mile map of the area for orientation purposes (see Figure B-3)

A list of Applicable Codes and Applicable Engineering Standards (most recent version) with which the application complies

Sheet index (table of contents) listing only submitted sheets

Seal and signature from a State of Texas-certified Professional Engineer (P.E.)

Professional Engineer's statement with the following signature line placed in the lower right-hand quadrant of the title page: