ࡱ> .0-q  bjbjt+t+ %(AA]L&&&&&&&&APEP$x&&&&&T&&&TTT&&&&T^T&&.STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION HELICOPTER LANDING AUTHORIZATION - APPLICATION DOA-0204 (Rev. 5/97) This application must be received by the Division of Aeronautics at least two weeks prior to date of landing. PLEASE PRINT OR TYPE AND COMPLETE ALL ITEMSPART I. HELICOPTER OPERATOR INFORMATIONNAME BUSINESS ADDRESS BUSINESS TELEPHONE NUMBER FAX NUMBER MAKE, MODEL AND NUMBER OF HELICOPTERS TO BE USED NUMBER OF LANDINGSDATE OF LANDINGSALTERNATIVE DATE(S) PRINT NAME SIGNATURE PART II. LANDING SITE INFORMATION COMPLETE SECTION A OR B AS APPROPRIATE A. IF ON SCHOOL PROPERTY, NAME OF SCHOOL ADDRESS BUSINESS TELEPHONE NUMBER FAX NUMBER I am aware of and do not object to the proposed helicopter landing at the site and on the date described in PART I. I also waive the right to demand a public hearing in accordance with Public Utilities Code Section 21662.5.SCHOOL OFFICIAL'S NAMETITLESIGNATURE B. IF NOT ON SCHOOL PROPERTY, PROPERTY OWNER'S NAME ADDRESS OF LANDING SITE BUSINESS ADDRESS BUSINESS TELEPHONE NUMBER FAX NUMBER I give permission for the helicopter listed in Part I of this form to conduct the landing. PRINT NAMESIGNATURE PART III. PERMISSION FROM OTHER SCHOOLS WITHIN 1,000 FEET COMPLETE BELOW OR PROVIDE SEPARATE LETTER(S) OF NO OBJECTIONI am aware of and do not object to the proposed helicopter landing at the site and on the date described in PART I. I also waive the right to demand a public hearing in accordance with Public Utilities Code Section 21662.5.NAME OF SCHOOL ADDRESS BUSINESS TELEPHONE NUMBER FAX NUMBER SCHOOL OFFICIAL'S NAMETITLESIGNATURE NAME OF SCHOOL ADDRESS BUSINESS TELEPHONE NUMBER FAX NUMBER SCHOOL OFFICIAL'S NAMETITLESIGNATURE Send complete application to address below or FAX to (916) 653-9531. CALIFORNIA DEPARTMENT OF TRANSPORTATION DIVISION OF AERONAUTICS - MS #40 P.O. BOX 942873 SACRAMENTO, 94273-0001DOA 91-0204 4bcx;<=CDVW&'MO{|G1 3 4    % & / 0 5 ߶5CJEHOJQJCJ EHOJQJ>*CJEHOJQJ CJOJQJCJEHOJQJEH5CJEHOJQJCJEHOJQJ56>*CJEHOJQJCJEHOJQJCJEHOJQJ EHOJQJ5EHOJQJCJEHOJQJ14cx<=BCDUVШL$$$l*($<$$$l*   $PP$$$l*$(($$($( 4cx<=BCDUVWqr~'OPz{|i   9:EFG2 3   $ % & . / 0 K L W X Y p v  bVWqr~q-$$l0(#*<$$-$$l0P*$$  $ $$l* 'OPz{`0sn($$$l* $<$$<$/$$lh0P*  $$-$$l0P* {|i(ɤɤ-$$l0*$$$l*($$$$l*   9:EFGhL-$$l0*$$l*$$+$$lF, *G2 3   $ % D$$l*($$$l*  $<$$<$+$$lF*$$ % & . / 0 K L W X Y p v (D+$$lF, *-$$l0*$($$$l* (+$$lF, *-$$l0*($<$$$l*$ 4 5 ^ j v    4 5 ^  $$l+$<$$$5 CJ EHOJQJCJEHOJQJ5CJEHOJQJ#0&P/ =!@"@#$% [0@0Normal@CJEHmH <A@<Default Paragraph Font(5 V{G%   x^~Mike Farmer Aero-54U:\POOL\FORMS\DOA-0204.DOCJFowler7\\T75RAIL-MAIN\DATA\AERONAUT\OA\FORMS\DOA-0204A.dot.docJFowler2\\T75RAIL-MAIN\DATA\AERONAUT\OA\FORMS\DOA-0204.DOT@HP LaserJet 4050 TN PSNe00:winspoolHP LaserJet 4050 Series PSHP LaserJet 4050 TN PSW odXLetterPRIV''''=HP LaserJet 4050 TN PSW odXLetterPRIV''''=jjHNj^P@GTimes New Roman5Symbol3& Arial"hCSjSFY $203STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION Mike Farmer Aero-54JFowlerOh+'0   0< X d p |4STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION TATMike Farmer Aero-54DEike Normal.dot JFowler3owMicrosoft Word 8.05@@@ 9#@3Y՜.+,D՜.+,@ hp  (California Department of Transportation 1 4STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION Title 6> _PID_GUIDAN{B32A7884-13E0-11D5-83FD-D4208675B548}  !"#$&'()*+,/Root Entry FL#>11TableWordDocument%(SummaryInformation(DocumentSummaryInformation8%CompObjjObjectPool>>  FMicrosoft Word Document MSWordDocWord.Document.89q