Form DOA-0100 "Airport Site Approval Permit - Application" - California

What Is Form DOA-0100?

This is a legal form that was released by the California Department of Transportation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2021;
  • The latest edition provided by the California Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DOA-0100 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

ADVERTISEMENT
ADVERTISEMENT

Download Form DOA-0100 "Airport Site Approval Permit - Application" - California

Download PDF

Fill PDF online

Rate (4.8 / 5) 17 votes
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
AIRPORT SITE APPROVAL PERMIT - APPLICATION
DOA-0100 (REV 04/2021)
PLEASE PRINT OR TYPE AND COMPLETE ALL APPLICABLE ITEMS
AIRPORT INFORMATION
AIRPORT NAME
NEAREST CITY
COUNTY
AIRPORT ADDRESS
BUSINESS PHONE
°
'
" N.
LATITUDE:
GEOGRAPHIC COORDINATES OF AIRPORT REFERENCE POINT
°
'
" W.
LONGITUDE:
OWNER INFORMATION
OWNER'S NAME
OWNER'S ADDRESS
BUSINESS PHONE
FAX NUMBER
EMAIL
AGENT'S NAME (if applicable)
AGENT'S ADDRESS
BUSINESS PHONE
FAX NUMBER
EMAIL
PROPERTY IS CONTROLLED BY:
Length of Lease
OTHER, SPECIFY
FEE
LEASE
PHYSICAL INFORMATION
PROPOSED AIRPORT USE:
FEET MSL
Public Use
Specific Use
Highest Elevation of Runway
Magnetic
Effective
Runway Data
Length
Width
Surface Type
Displaced Threshold
Right Traffic
Bearing
Gradient %
1
st
Runway
FEET
FEET
/
nd
FEET
FEET
2
Runway
/
TRAFFIC PATTERN ALTITUDE
WILL AIRPORT BE LIGHTED FOR NIGHT OPERATIONS?
YES
NO
DIRECTION OF PREVAILING WIND
MEAN DAILY MAX TEMPERATURE IN HOTTEST MONTH
ANTICIPATED CONSTRUCTION DATES:
START
COMPLETION
CERTIFICATION
I HEREBY CERTIFY THAT I AM AUTHORIZED TO SUBMIT THIS APPLICATION
OWNER OR AGENT'S SIGNATURE
TITLE
DATE
PRINT NAME
PHONE
EMAIL
SUBMIT COMPLETED AIRPORT SITE APPROVAL PERMIT APPLICATION FORM ALONG WITH ALL REQUIRED
DOCUMENTS. CLICK SUBMIT TO SEND THE FORM AND YOUR ATTACHMENTS TO THE DIVISION OF AERONAUTICS.
SUBMIT
OR, SCAN THE COMPLETED FORM WITH YOUR ATTACHMENTS AND EMAIL TO:
AIRPORTS@DOT.CA.GOV
Page 1 of 2
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
AIRPORT SITE APPROVAL PERMIT - APPLICATION
DOA-0100 (REV 04/2021)
PLEASE PRINT OR TYPE AND COMPLETE ALL APPLICABLE ITEMS
AIRPORT INFORMATION
AIRPORT NAME
NEAREST CITY
COUNTY
AIRPORT ADDRESS
BUSINESS PHONE
°
'
" N.
LATITUDE:
GEOGRAPHIC COORDINATES OF AIRPORT REFERENCE POINT
°
'
" W.
LONGITUDE:
OWNER INFORMATION
OWNER'S NAME
OWNER'S ADDRESS
BUSINESS PHONE
FAX NUMBER
EMAIL
AGENT'S NAME (if applicable)
AGENT'S ADDRESS
BUSINESS PHONE
FAX NUMBER
EMAIL
PROPERTY IS CONTROLLED BY:
Length of Lease
OTHER, SPECIFY
FEE
LEASE
PHYSICAL INFORMATION
PROPOSED AIRPORT USE:
FEET MSL
Public Use
Specific Use
Highest Elevation of Runway
Magnetic
Effective
Runway Data
Length
Width
Surface Type
Displaced Threshold
Right Traffic
Bearing
Gradient %
1
st
Runway
FEET
FEET
/
nd
FEET
FEET
2
Runway
/
TRAFFIC PATTERN ALTITUDE
WILL AIRPORT BE LIGHTED FOR NIGHT OPERATIONS?
YES
NO
DIRECTION OF PREVAILING WIND
MEAN DAILY MAX TEMPERATURE IN HOTTEST MONTH
ANTICIPATED CONSTRUCTION DATES:
START
COMPLETION
CERTIFICATION
I HEREBY CERTIFY THAT I AM AUTHORIZED TO SUBMIT THIS APPLICATION
OWNER OR AGENT'S SIGNATURE
TITLE
DATE
PRINT NAME
PHONE
EMAIL
SUBMIT COMPLETED AIRPORT SITE APPROVAL PERMIT APPLICATION FORM ALONG WITH ALL REQUIRED
DOCUMENTS. CLICK SUBMIT TO SEND THE FORM AND YOUR ATTACHMENTS TO THE DIVISION OF AERONAUTICS.
SUBMIT
OR, SCAN THE COMPLETED FORM WITH YOUR ATTACHMENTS AND EMAIL TO:
AIRPORTS@DOT.CA.GOV
Page 1 of 2
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
AIRPORT SITE APPROVAL PERMIT - APPLICATION
DOA-0100 (REV 04/2021)
PLEASE PRINT OR TYPE AND COMPLETE ALL APPLICABLE ITEMS
REQUIRED DOCUMENTS LIST
Please submit the following as described in the California Code of Regulations, Section 3534 of Title 21,
For Caltrans/Aeronautics Use Only
Airports and Heliports with this Application:
Initials/Date
Two copies of scaled drawings of the airport and adjoining areas. See Title 21, Section 3534(b)(1)
/
for required details.
Topographic map that shows the location and altitude of the aircraft traffic patterns relative to the
/
airport.
Local area map of drawing depicting the airport and the location of schools, places of public
/
gatherings and residential areas within two miles of the centerline of a proposed runway.
Documentation of approval of the plan for construction by either the Board of Supervisors of the
/
county or the City Council of the city (as appropriate) in which the airport is to be located.
Documentation of action by the Airport Land Use Commission of the county in which the airport is to
/
be located (as appropriate).
Documentation of compliance with the California Environmental Quality Act.
/
Documentation showing ownership of the airport. The owner, for purpose of this permit, is the
person with the authority to possess the facility, which may be in fee simple or a leasehold for a
/
period of at least one year.
FAA Airspace Determination regarding the airport. Enclosed is FAA Form 7480-1 (Notice of Landing
Area Proposal), which must be completed and mailed to the FAA at the address indicated on the
/
form.
Page 2 of 2
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
Page of 2