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REVIEWED RESUB 1 FIR2023-0068+SIGNED_LOPA+7.27.2023_8.11.31_AM+3691789a101141 G11111041:3 SNOHOMISH R E S U B COUNTY Jul 27 2023 911 Letter of Provisional Authorization DEVCITY E O MFEN SOERVICES DEPARTMENT �y_( g Authorization is granted to the Owner and/or Facility Manager as shown below, for the purpose of rebroadcasting the Snohomish County 911 public safety frequencies using class "A" bi-directional amplifiers (BDA's) or Distributive Antenna Systems (DAS). Class "B" BDA/DAS systems will not be granted authorization to retransmit on the Snohomish County 911 radio system. Facility Name: Anthology of Edmonds Address: 21200 72nd Ave. West City: Edmonds State: Wa JZip Code: 98026 Buisness Phone: 425-329-7152 Owner/Contact Name: lAnthology Senior Livin Address: 2401 E. 2nd Ave. Ste. 500 City: Denver tate: co I Zip Code: Phone: 248-266-2263 Email: information(cDanthologvseniorlivinq.com TO BE FILLED OUT BY SN0911 SERS System Donor Site Assignment: OWest Simulcast O Darrington Index IR O East Simulcast 0Skykomish I BDA/DAS Manufacturer: lComba BDA/DAS Model: RX08V3-A3327P0-S1 Latitude of Donor Antenna: N 47 48 24 Longitude of Donor Antenna: W 122 19 50 Donor Antenna Height: 188ft ASL TO BE FILLED OUT BY SN0911 SN0911 Site Name:lMountlake Terrace Site Distance: 1 mile Donor Antenna Heading: 11260 This form is authorization to rebroadcast on the Snohomish County 911 radio frequencies. This is not approval from the Fire Marshall or Authority having Jurisdiction that the system meets necessary codes or coverage requirements. Snohomish County 911 and the Fire Marshall reserve the right to make on -site inspections at any time. If problems are believed to exist, the Owner and/or Facility Manager shall power -off their DAS or BDA equipment at Snohomish County 911's request. Snohomish County 911 also reserves the right to suspend or terminate this agreement at its discretion. rla"�Q' 07/27/2023 Snohomish County 61 Representative Date Cabe Bartz Print or Type Name 1121 SE Everett Mall Way, Suite 200 www.sno9ll.org Office: (425) 407-3911