hereby applies for an operating license for the

Airport/Heliport, as required by South Dakota Codified Law

50-5-1. This license is for operating the airport/heliport as: (pick one)

A public facility open to the public in the state of South Dakota

A restricted-use airport/heliport for private use only, not open to the public, in the state of South Dakota.

The airport/heliport is located in Section ,Township , Range ,
AURORA BEADLE BENNETT BON HOMME BROOKINGS BROWN BRULE BUFFALO BUTTE CAMPBELL CHARLES MIX CLARK CLAY CODINGTON CORSON CUSTER DAVISON DAY DEUEL DEWEY DOUGLAS EDMUNDS FALL RIVER FAULK GRANT GREGORY HAAKON HAMLIN HAND HANSON HARDING HUGHES HUTCHINSON HYDE JACKSON JERAULD JONES KINGSBURY LAKE LAWRENCE LINCOLN LYMAN MARSHALL MCCOOK MCPHERSON MEADE MELLETTE MINER MINNEHAHA MOODY OGLALA LAKOTA PENNINGTON PERKINS POTTER ROBERTS SANBORN SPINK STANLEY SULLY TODD TRIPP TURNER UNION WALWORTH YANKTON ZIEBACH County, South Dakota. Latitude Longitude

Has FAA 7480 been filed? Yes No If yes, date of filing:

Study no.

Has approval been received from: (check all that apply)
City
County
State

I hereby request South Dakota Aeronautics Commission representatives to inspect the
above-named airport/heliport and issue an operating license authorizing the
to operate the Airport/Heliport
in the state of South Dakota.

Submitted on

by
_____________________________________________
Signature

Title


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