"Application for Waiver of Minimum Requirements to a Public-Use Airport License" - Virginia

Application for Waiver of Minimum Requirements to a Public-Use Airport License is a legal document that was released by the Virginia Department of Aviation - a government authority operating within Virginia.

Form Details:

  • Released on December 18, 2013;
  • The latest edition currently provided by the Virginia Department of Aviation;
  • Ready to use and print;
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  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Virginia Department of Aviation.

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Commonwealth of Virginia
For DOAV Use Only
DATE STAMP BELOW
Department of Aviation
5702 Gulfstream Road
Richmond, VA 23250-2422
www.doav.virginia.gov
Application for Waiver of Minimum Requirements to a Public-use Airport License
Instructions
Use this application to request a waiver to minimum requirements to a public-use airport license.
Complete Parts 1 through 3.
Send the application and all supporting information to the Airport Services Division of the Virginia Department of Aviation.
Part 1: Airport and Applicant Information
Name of Airport:
Name of Sponsor:
Address of Sponsor:
Name of Contact Person:
Phone for Contact Person:
Email for Contact Person:
Part 2: Waiver Request
The Virginia Administrative Code, 24VAC5-20-145 Waiver of minimum requirements, provides that the
Virginia Aviation Board may waive the compliance of requirements of 24VAC5-20-140 for an airport upon
an application by an airport sponsor. Considerations for granting the waiver shall be limited to (i) a
determination of no hazard based on a Federal Aviation Administration (FAA) airspace evaluation and
implementation of mitigation recommendations if applicable, (ii) a determination of impracticality due to
topography, or (iii) a benefit cost analysis proving improvements as financially unfeasible.
In the space below, please identify the requirement(s) for which a waiver is being requested and clearly
explain why the requirement(s) cannot be met. Supporting information, such as FAA documentation or a
cost analysis, must be provided with the application.
Reason for waiver request:
200 DOAVAS 20131218 Application for Waiver of Minimum Requirements to a Public-use Airport License
Page 1 of 2
Commonwealth of Virginia
For DOAV Use Only
DATE STAMP BELOW
Department of Aviation
5702 Gulfstream Road
Richmond, VA 23250-2422
www.doav.virginia.gov
Application for Waiver of Minimum Requirements to a Public-use Airport License
Instructions
Use this application to request a waiver to minimum requirements to a public-use airport license.
Complete Parts 1 through 3.
Send the application and all supporting information to the Airport Services Division of the Virginia Department of Aviation.
Part 1: Airport and Applicant Information
Name of Airport:
Name of Sponsor:
Address of Sponsor:
Name of Contact Person:
Phone for Contact Person:
Email for Contact Person:
Part 2: Waiver Request
The Virginia Administrative Code, 24VAC5-20-145 Waiver of minimum requirements, provides that the
Virginia Aviation Board may waive the compliance of requirements of 24VAC5-20-140 for an airport upon
an application by an airport sponsor. Considerations for granting the waiver shall be limited to (i) a
determination of no hazard based on a Federal Aviation Administration (FAA) airspace evaluation and
implementation of mitigation recommendations if applicable, (ii) a determination of impracticality due to
topography, or (iii) a benefit cost analysis proving improvements as financially unfeasible.
In the space below, please identify the requirement(s) for which a waiver is being requested and clearly
explain why the requirement(s) cannot be met. Supporting information, such as FAA documentation or a
cost analysis, must be provided with the application.
Reason for waiver request:
200 DOAVAS 20131218 Application for Waiver of Minimum Requirements to a Public-use Airport License
Page 1 of 2
Application for Waiver of Minimum Requirements to a Public-use Airport License
Part 3: Applicant Certification
The undersigned submits this application to the Virginia Aviation Board and Virginia Department of
Aviation in accordance with Virginia Administrative Code 24VAC5-20-145 Waiver of minimum
requirements. The undersigned certifies that they are the sponsor, or the authorized representative for
the sponsor, of the airport for which this license waiver is being sought.
The undersigned acknowledges that the waiver requested will not be issued by the Virginia Aviation
Board unless and until all supporting materials as noted herein have been properly submitted and
approved.
Signature of Sponsor or Authorized Representative
Title
Date
Phone
Part 4: Virginia Department of Aviation Action (agency use only)
Waiver issued or denied:
Application received:
New license issued:
Supporting information received:
DOAV review:
200 DOAVAS 20131218 Application for Waiver of Minimum Requirements to a Public-use Airport License
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