gaca_gov_sa · form · processed · 3 chunks
GACA العربيه العابه للطيران المدني General Authority of Civil Aviation [Non-Text] APPLICATION FORM FOR ESTABLISHMENT OF NEW AERODROME (Information to be filled with by the Applicant) INSTRUCTIONS A. This form is to be filled with by the Applicant for permission to establish of new aerodrome. B. No part must be left blank. Write Not Applicable, if the information to be filled does not pertain to the aerodrome or applicant. C. For any clarification contact the General Manager (Aerodrome Standards Department) of General Authority of Civil Aviation, Kingdom of Saudi Arabia. 1. PARTICULARS OF THE APPLICANT <table><tr><td>Full Name</td><td colspan="3"></td></tr><tr><td>Position/Title</td><td colspan="3"></td></tr><tr><td>Address</td><td colspan="3"></td></tr><tr><td>Phone</td><td></td><td>Mobile</td><td></td></tr><tr><td>Email</td><td></td><td>Fax</td><td></td></tr><tr><td colspan="4">Nationality of the Applicant</td></tr></table> 2. DETAILS OF THE AERODROME SITE <table><tr><td>Aerodrome Name</td><td></td></tr><tr><td colspan="2">Geographical Coordinates of the Aerodrome in degrees, minutes and seconds of WGS-84 format.</td></tr><tr><td>Longitude</td><td>Latitude</td></tr><tr><td>Location/Name of City</td><td></td></tr></table> 3. IS APPLICANT OWNER OF THE AERODROME SITE? PLEASE TICK MARK (√) ONE OF THE BOX <table><tr><td>□ Yes</td><td>□ No</td></tr><tr><td colspan="2">If No, Provide;Details of Rights Held/Lease Deed in Relation to the Site (Attach agreement copy); and</td></tr><tr><td colspan="2">Name and address of the Owner of the Aerodrome Site</td></tr></table> 4. CLASSIFICATION OF AERODROME (TYPE OF USE)? PLEASE TICK MARK (√) ONE OF THE BOX. <table><tr><td colspan="3">Classification of Aerodrome</td></tr><tr><td>□</td><td>Civil/Public</td><td>□ General Aviation</td></tr><tr><td colspan="3">Aerodrome reference code</td></tr><tr><td colspan="3">Type of Runway/Landing Strip</td></tr><tr><td colspan="3">(Non -Instrument/Non-Precision/Precision CAT-I/Precision CAT-II/Precision CAT-III)</td></tr></table> 5. APPLICATION REQUIREMENTS FOR PERMISSION <table><tr><td>a) Applicant in a prescribed form</td></tr><tr><td>b) Land ownership proof or Lease Agreement</td></tr><tr><td>c) Approval from Local Province Municipality</td></tr><tr><td>d) No objection or Agreement from SANS</td></tr><tr><td>e) Environmental Impact Assessment Report</td></tr><tr><td>f) Aerodrome Feasibility Study Report including:1) Details of the aircrafts mix fleet and critical aircraft.2) Type of the operations.3) Runway orientation siting details with wind data and wind rose analysis, approach and take-off climb surfaces orientation as per GACAR Part 139 requirements.</td></tr></table> GACA-AVSES-AGA-F004 Rev: 6, Date: 25 Mar 25 Page 1 of 2 GACA العربيه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] APPLICATION FORM FOR ESTABLISHMENT OF NEW AERODROME 4) Runway length design considers critical aircraft and correction factors for the elevation, temperature and runway slope with site temperature data and calculations of the aerodrome reference temperature as per GACAR Part 139 requirements. 5) Aerodrome design and master plan with dimensions of runway(s), taxiways, RESA, Stop ways, Clearways Strips, aprons, RFF, ATC etc., visual aids - markings and lightings etc. 6) Obstacle Survey Report with obstacle limitation surfaces of the proposed runway(s). 7) Study report on Air Traffic in the vicinity of the aerodrome. 8) Aeronautical study; if applicable. 9) Proposed master plan showing the current and future land uses of the aerodrome. 10) Any other relevant documents. 6. DETAILS TO THE CONSULTANT ENTITY <table><tr><td>Name of the Consultant</td><td></td></tr><tr><td>Address of the Consultant(Saudi Arabia and Outside with contact details)</td><td></td></tr><tr><td>Type of Firm(Individual/JV/Government)</td><td></td></tr><tr><td>Whether accepted by President of GACA(If yes, attached copy of acceptance letter)</td><td></td></tr></table> 7. UNDERTAKING BY THE APPLICANT <table><tr><td colspan="2">On behalf of the applicant/owner, I certify that all above information is correct to best of my knowledge and I hereby apply in the prescribed forms for the issuance of permission to establish new aerodrome. Once permission is granted, I undertake that we shall inform the President of GACA on completion of the project and apply for certification or authorization of aerodrome as per requirement of GACAR Part 139 before start of any operation on the aerodrome.</td></tr><tr><td>Signature of the Applicant/Owner</td><td>Name</td></tr><tr><td></td><td></td></tr><tr><td>Position held</td><td>Date</td></tr><tr><td></td><td></td></tr></table> 8. LIST OF DOCUMENTS TO BE ATTACHED ALONG WITH THIS FORM 1. Statement of Regulation Compliances (Form: ASD-139-1631); 2. Aerodrome Feasibility Study Report with all documents listed in feasibility report. 3. Any other relevant documents, if any GACA-AVSES-AGA-F004 Rev: 6, Date: 25 Mar 25 Page 2 of 2