Form AV-14 "Uas Flight Request Form" - Pennsylvania

What Is Form AV-14?

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

Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the Pennsylvania 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 AV-14 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Transportation.

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Download Form AV-14 "Uas Flight Request Form" - Pennsylvania

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AV-14 (7-19)
UAS FLIGHT REQUEST FORM
www.penndot.gov
FLIGHT PERSONNEL & EQUIPMENT
Remote PIC:
UAS Make:
PennDOT Cert. #:
Model:
Mission Observer:
Addl Aircraft:
IF THIRD PARTY
Organization Name:
FLIGHT INFORMATION
Date(s):
Project Name:
Location:
Purpose of Flt:
Municipality:
Projected # Flts:
RISK ASSESSMENT
Complexity of Mission
Controlled Airspace
Nearby Airport/Heliport
Simple
Class G
None nearby > 3 mile
L
L
L
Moderate
Class E
Nearby 1-3 miles
M
L
M
H
M
M
Complex
Class B-D
Close Proximity < 1 mile
Wires/Trees/Structures
Proximity to Roads
Pedestrians/distraction
Not present
Not over open roads
Not present
L
L
L
M
M
L
Nearby > 100'
Open roadway < 40'
Nearby uncontrolled
M
H
M
Present
Over open roads
Close Proximity
Drone Distance from Operator
Private Property
Over Water
Vertical Dist < 300'
N/A or Permission
Not over water
L
L
L
M
L
L
Vertical Dist > 300'
Nearby > 50'
Near water
M
M
M
Hor Dist. > 400 yards
Over or < 10 feet
Over water
Winds
Daylight
RF Dead Spots
Winds < 15 knots
Daytime only
Unlikely
L
L
L
M
M
M
Winds 15-25 knots
During Dawn / Dusk
Possible
H
H
H
Winds > 25 knots
Nighttime
Likely
Chance of Precipitation
Visibility
Cloud Base
None
Greather than 3 mile
>1,000' AGL
L
L
L
L
M
L
< 50%
Chance of low vis
Chance of < 1,000'
M
H
M
>50%
Forcast < 3 mile
< 700' AGL
Private Property Coordination Rqd?
YES
NO
Notice of Intent to Enter Rqd?
YES
NO
Fill in highest rating from above
Airport/Heliport Coordination Rqd?
YES
NO
Overall Risk
CERTIFICATION
UAS Remote PIC Signature:
Title:
PennDOT Signature:
Title:
Instructions: Remote PIC is responsible for obtaining PennDOT approval and coordinating flight activities as appropriate before flight.
Include sketches or diagrams as necessary to detail area of operation and proposed flight path(s).
Sketch should include launch and recovery points, observation points, applicable right of ways and property lines, and known hazard areas.
Mitigation measures should be explained on page 2 for all 'medium' and 'high' risks.
Provide weather forecast with Flight Request Form and obtain updated forecast immediately prior to each proposed mission.
AV-14 (7-19)
UAS FLIGHT REQUEST FORM
www.penndot.gov
FLIGHT PERSONNEL & EQUIPMENT
Remote PIC:
UAS Make:
PennDOT Cert. #:
Model:
Mission Observer:
Addl Aircraft:
IF THIRD PARTY
Organization Name:
FLIGHT INFORMATION
Date(s):
Project Name:
Location:
Purpose of Flt:
Municipality:
Projected # Flts:
RISK ASSESSMENT
Complexity of Mission
Controlled Airspace
Nearby Airport/Heliport
Simple
Class G
None nearby > 3 mile
L
L
L
Moderate
Class E
Nearby 1-3 miles
M
L
M
H
M
M
Complex
Class B-D
Close Proximity < 1 mile
Wires/Trees/Structures
Proximity to Roads
Pedestrians/distraction
Not present
Not over open roads
Not present
L
L
L
M
M
L
Nearby > 100'
Open roadway < 40'
Nearby uncontrolled
M
H
M
Present
Over open roads
Close Proximity
Drone Distance from Operator
Private Property
Over Water
Vertical Dist < 300'
N/A or Permission
Not over water
L
L
L
M
L
L
Vertical Dist > 300'
Nearby > 50'
Near water
M
M
M
Hor Dist. > 400 yards
Over or < 10 feet
Over water
Winds
Daylight
RF Dead Spots
Winds < 15 knots
Daytime only
Unlikely
L
L
L
M
M
M
Winds 15-25 knots
During Dawn / Dusk
Possible
H
H
H
Winds > 25 knots
Nighttime
Likely
Chance of Precipitation
Visibility
Cloud Base
None
Greather than 3 mile
>1,000' AGL
L
L
L
L
M
L
< 50%
Chance of low vis
Chance of < 1,000'
M
H
M
>50%
Forcast < 3 mile
< 700' AGL
Private Property Coordination Rqd?
YES
NO
Notice of Intent to Enter Rqd?
YES
NO
Fill in highest rating from above
Airport/Heliport Coordination Rqd?
YES
NO
Overall Risk
CERTIFICATION
UAS Remote PIC Signature:
Title:
PennDOT Signature:
Title:
Instructions: Remote PIC is responsible for obtaining PennDOT approval and coordinating flight activities as appropriate before flight.
Include sketches or diagrams as necessary to detail area of operation and proposed flight path(s).
Sketch should include launch and recovery points, observation points, applicable right of ways and property lines, and known hazard areas.
Mitigation measures should be explained on page 2 for all 'medium' and 'high' risks.
Provide weather forecast with Flight Request Form and obtain updated forecast immediately prior to each proposed mission.
PennDOT UAS FLIGHT REQUEST FORM
Mitigation measures should be explained for each 'Medium' or 'High' risk on page 1
Hazard Mitigation Measures
Hazard
Action
Notes/Comments
Page of 2