Title Page
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CPE Site Name:
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CPE Location Address
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Prepared by
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Conducted on
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Screenshot of Collector fiber route into customer premises:
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The Owner of the premises described above hereby consents to the installation, operation, and maintenance by Southern Light Fiber, LLC, on behalf of its affiliates (together, "Southern Light"), at Southern Light's sole cost and expense, of Southern Light's fiber optic cable and other equipment into, over, under, across, and along the Property, to be used by Southern Light to provide communications services to tenants and other occupants of the property.
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Property Owner's Signature