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<br />@ Southwestern Bell <br />Telephone <br /> <br />SW-9436A <br />(Rev. 5-89) <br />Ref: 002-011-900SW <br /> <br />NOTIFICATION OF SURRENDER OR MODIFICATION <br />OF POLE ATTACHMENT LICENSE BY LICENSEE <br /> <br />Page_ of _ <br /> <br />Agreement Number <br /> <br />The City of Paris, Paris, Texas <br />(Licen.ce) <br /> <br />(Addle..) <br /> <br />Southwestern Bell Telephone Company; <br /> <br />In accordance with the terms and conditions of the License A&I'eement between us, dated . 19_, notice <br />is hereby gi....n that the licenses covering anac:hments to the foUowing poles and/or anchors andlor utilization of anchor/guy <br />strand is surrendered (or modified as indicated in Licensee' 5 prior nolificalion to Licensor. dated , 19 ~ <br />eC(ective **** ** ** ** **** ** ** *** * ** * * * *** ** * *** *,< ** * <br /> <br />2 <br /> <br /> DATE FAC. <br />POLE NO. ANCHOR A/OS LIC. NO. &. DATE SURRENDEER OR MODIFICATION RMVD. OR <br /> (ASSOC. POLE NO.) MODIFIED <br /> <br />3 <br /> <br />4 <br /> <br />5 <br /> <br />6 <br /> <br />7 <br /> <br />8 <br /> <br />9 <br /> <br />10 <br /> <br />11 <br />12 <br /> <br />13 <br />14 <br />IS <br /> <br />Date Nolifiealion Received <br />Dale Modification Accepted <br />By <br />Discontinued: <br />Non-Video Pol.. <br />Video Poles_ Anehon <br />Anchor/Guy Strands <br /> <br />Name of Licen.ee <br /> <br />By <br /> <br />Title <br />