In USA, the local operator refused to offer ADSL services to a small community lost in Colorado. They decided to become their own provider and bought a DSLAM, a router and all the material needed to build their POP! The most difficulties were to buy cheap bandwidth and to block a complaint of the FCC (Federal Commission of Telecommunications)
See also:
http://www.business2.com/articles/mag/0,1640,42126,FF.html
http://www.foxnews.com/printer_friendly_story/0,3566,60525,00.html
http://www.nwfusion.com/columnists/2002/0408netbuzz.html