| Section | Question | Response |
|---|---|---|
| Attachments | Are attachments (other than associated schedules) being filed with this application? | No |
| Applicant | Address | Phone | Applicant Type | |
|---|---|---|---|---|
|
Cache County |
David Zook 199 North Main Street Logan, Utah, UT 84321 United States |
+1 (435) 755-1850 |
david.zook@cachecounty.org |
Government Entity |
| Contact Name | Address | Phone | Contact Type | |
|---|---|---|---|---|
|
Michael D Braegger Field Engineer Cache County |
Michael D. Braegger 886 East 200 South Brigham City, UT 84302 United States |
+1 (801) 598-0107 |
bsecurllc@gmail.com |
Technical Representative |
| Date of Consummation | FRN of Licensee Post-consummation |
|---|---|
| 2022-01-21 | 0006950653 |
Select all the authorizations in the table below that will not be consummated
| Call Sign | Facility ID | File Number | Will Not Consummate |
|---|---|---|---|
| K17II-D | 168494 | 0000170363 |
| Section | Question | Response |
|---|---|---|
| Authorized Party to Sign | WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Title 18, §1001) AND/OR REVOCATION OF ANY STATION AUTHORIZATION (U.S. Code, Title 47, §312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, §503). |
|
| I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Michael DeVon Braegger Field Engineer 01/21/2022 |
