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1 age 1 of 17 FCC FORM FEDERAL COMMUNICATIONS COMMISSION ALICATION FOR NEW OR MODIFIED RADIO STATION UNDER ART 5 OF FCC RULES - EXERIMENTAL RADIO SERVICE (OTHER THAN BROADCAST) 1. Applicant's Name (company) American Radio Relay League, Inc. 2. Mailing Address: Attention: Christopher D. Imlay Address: 225 Main.O. Box: City: ington State: CT Zip Code: Country: Address: W3KD@ARRL.ORG 3(a). Application is for: NEW LICENSE 3(b). For Modification indicate below: File No: Callsign: 4. Is this authorization to be used for fulfilling the requirement of a government contract with an agency of the United States Government? If "YES", include as an exhibit a narrative statement describing the government project, agency and contract number. 5. Is this authorization to be used for the exclusive purpose of developing radio equipment for export to be employed by stations under the jurisdiction of a foreign government? If "YES", include the contract number and the name of the foreign government concerned as an exhibit. 6. Is this authorization to be used for providing communications essential to a research project? (The radio communication is not the objective of the research project)? If "YES", include as an exhibit the following information: Approved by OMB Expires 09/30/98 File No EX- L-2005 No No No a. A description of the nature of the research project being conducted. b. A showing that the communications facilities requested are necessary for the research project involved. c. A showing that existing communications facilities are inadequete. 7. If all the answers to Items 4, 5, 6 are "NO", include as an exhibit a narrative statement describing in detail the following items: a. The complete program of research and experimentation proposed including description of equipment and theory of operation. b. The specific objectives sought to be accomplished. c. How the program of experimentation has a reasonable promise of contribution to the development, extension, expansion or utilization of the radio art, or is along line not already investigated. 8. Give an estimate of the length of time that will be required to complete the program of experimentation proposed in this application: 9. Would a commission grant of this application come within Section of the FCC Rules, such that it may have a significant environmental impact? If "YES", include as an exhibit an Environmental Assessment as required by Section Months 10. List below transmitting equipment to be installed (if experimental, so state) if additional rows are required, please submit equipment list as an exhibit : Manufacturer Model Number No. Of Units Experimental Various 23 No No 11. Is the equipment listed in Item 10 capable of station identification pursuant to Section 5.115? Yes
2 age 2 of Applicant is: Association 13. Is applicant a foreign government or a representative of a foreign government? No 14. Has applicant or any party to this application had any FCC station license or permit revoked or any application for permit, license or renewal denied by this Commission? If "YES", include as an exhibit a statement giving call sign of license or permit revoked and relate circumstances. 15. Will applicant be owner and operator of the station? No 16. Give the following information of person who can best handle inquiries pertaining to this application: First Name: Frederick Last Name: Raab Title: Experimental roject Manager hone Number: Address: f.raab@ieee.org 17. ALICANT ANTI-DRUG ABUSE CERTIFICATION: By checking "YES", the individual applicant certifies that he or she is eligible for this license. This requires that he or she is not subject to a denial of federal benefits, including FCC benefits, as a result of a drug offense conviction pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C A non-individual applicant, e.g., corporation. partnership or other unincorporated association, certifies that no party to the application is subject to a denial of federal benefits, pursuant to that section. For definition of a "party" for these purposes, see 47CFR (b). 18. CERTIFICATION: THE ALICANT CERTIFIES THAT: No Yes a. Copies of the FCC Rule arts 2 and 5 are on hand; and b. Adequete financial appropriations have been made to carry on the program of experimentation which will be conducted by qualified personnel; and c. All operations will be on an experimental basis in accordance with art 5 and other applicable rules, and will be conducted in such a manner and at such a time as to preclude harmful interference to any authorized station; and d. Grant of the authorization requested herein will not be construed as a finding on the part of the Commission: 1. that the frequencies and other technical parameters specified in the authorization are the best suited for the proposed program of experimentation, and 2. that the applicant will be authorized to operate on any basis other than experimental, and 3. that the Comission is obligated by the results of the experimental program to make provision in its rules including its table of frequency allocations for applicant's type of operation on a regularly licensed basis. THE ALICANT FURTHER CERTIFIES THAT: e. All the statements in the application and attached exhibits are true, complete and correct to the best of the applicant's knowledge; and f. The applicant is willing to finance and conduct the experimental program with full knowledge and understanding of the above limitations; and g. The applicant waives any claim to the use of any particular frequency or of the electromagnetic spectrum as against the regulatory power of the USA. Name of Applicant: American Radio Relay League, Inc. Signature (Authorized person filing form): David Sumner Signature Date (Authorized person filing form): 04/04/2005 Title of erson Signing Application: Executive Vice resident ification: Office of applicant corporation or association WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE UNISHABLE BY FINE AND/OR
3 age 3 of 17 IMRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION ERMIT (U.S. CODE, TITLE 47, SECTION 312(A)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503). NOTIFICATION TO INDIVIDUALS UNDER RIVACY ACT OF 1974 AND THE AERWORK REDUCTION ACT OF 1980 Information requested through this form is authorized by the Communications Act of 1934, as amended, and specified by Section 308 therein. The information will be used by Federal Communications Commission staff to determine eligibility for issuing authorizations in the use of the frequency spectrum and to effect the provisions of regulatory responsibilities rendered by the Commission by the Act. Information requested by this form will be available to the public unless otherwise requested pursuant to 47 CFR of the FCC Rules and Regulations. Your response is required to obtain this authorization. ublic reporting burden for this collection of information is estimated to average four (4) hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden to the Federal Communications Commission, Records Management Branch, aperwork Reduction roject ( ), Washington DC DO NOT send completed applications to this address. Individuals are not required to respond to this collection unless it displays a currently valid OMD control number. THE FOREGOING NOTICE IS REQUIRED BY THE RIVACY ACT OF 1974,.L , DECEMBER 31, 1974, 5 U.S.C. 552a(e)(3), AND THE AERWORK REDUCTION ACT OF 1980,.L , DECEMBER 11, 1980, 44 U.S.C Location City State Latitude Longitude (1) Jamestown RI North West Mobile: 761 Beavertail Road (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: N/A / N/A
4 age 4 of 17 (2) Hammond LA North West Mobile: Edgar Traylor Road (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: 8.00 (c) Distance to nearest aircraft landing area in kilometers: (3) Rhome TX North West Mobile: 211 Hidden Meadow Court (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters:
5 age 5 of 17 (c) Distance to nearest aircraft landing area in kilometers: aircraft: existing antennna (4) Burbank CA North West Mobile: 1054 East Olive Avenue (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: 6.00 (5) Bow NH North West Mobile: 9 Dean Avenue
6 age 6 of 17 (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: HA1A 50 baud 60H0J2B baud (6) Long Beach MS North West Mobile: 1157 East Old ass Road (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: 7.00 (c) Distance to nearest aircraft landing area in kilometers:
7 age 7 of 17 (7) Jefferson LA North West Mobile: 715 Jefferson Heights Avenue (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: 2.00 (c) Distance to nearest aircraft landing area in kilometers: 8.00 (8) McLean VA North West Mobile: 6915 Chelsea Road
8 age 8 of 17 (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: (9) Jamestown NJ North West Mobile: 14 Washington (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers:
9 age 9 of 17 (10) Stanfield NC North West Mobile: less Mill Road (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: (11) Cookeville TN North West Mobile: 3927 Huntington Drive (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers:
10 age 10 of 17 (12) Nederland CO North West Mobile: 536 Hurricane Hill Drive (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: (13) Verndale MN North West Mobile: st
11 age 11 of 17 (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: (14) Colchester VT North West Mobile: 77 Vermont Avenue (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: 5.00 (15) Roland AR North West Mobile:
12 age 12 of Barrett Road mounted on an existing structure other than a building? No (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: aircraft: (16) St. Francis MN North West Mobile: th Ave., NW (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers:
13 age 13 of 17 (17) Marshfield MA North West Mobile: 11 Walnut (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: 3.00 (18) Green Harbor MA North West Mobile: 19 earl
14 age 14 of 17 (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: 6.00 (c) Distance to nearest aircraft landing area in kilometers: 0.32 (19) Batavia IL North West Mobile: 314 S. Harrison (a) Overall height above ground to tip of antenna in meters: 9.00 (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: (20) Cottage Grove OR North West Mobile:
15 age 15 of Fox Lane (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: (21) Colorado Springs CO North West Mobile: 905 Zodiac Drive (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers:
16 age 16 of 17 (22) Buffalo NY North West Mobile: 445 Shirley Avenue (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: (23) Wyland MA North West Mobile: 157 lain Road
17 age 17 of 17 (a) Overall height above ground to tip of antenna in meters: (b) Elevation of ground at antenna site above mean sea level in meters: (c) Distance to nearest aircraft landing area in kilometers: K15A1A 50 baud 0K06J2B baud
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