Initial Application Page 1

MANITOBA AIRPORTS ASSISTANCE PROGRAM - MAAP

INITIAL APPLICATION

Mail to: Northern Airports and Marine Operations Manitoba Infrastructure & Transportation 310 - 215 Garry Street Winnipeg, Manitoba R3C 3P3

1. Airport Name: (As listed in the CFS) ____________________________________________________ 2. Operated by: (Name of Local Airport Commission)

_______________________________________________________________ 3. Mailing address of Airport Commission:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________ 4. Telephone at Airport Commission: ___________________________________ 5. Telephone at Airport: ______________________________________________ 6. Towns and Municipalities represented on Airport Commission:

Town or RM Name of Representative

__________________ _________________________________

__________________ _________________________________

__________________ _________________________________

__________________ _________________________________

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7. List officers of Local Airport Commission

______________________ ______________________

______________________ ______________________

______________________ ______________________

______________________ ______________________ 8. Does the Airport Commission operate the airport itself?

_____ yes ____ no

If no, please provide name, address and telephone number of those operating the airport for Local Airport Commission.

Name: ________________________________________________________

Organization: ___________________________________________________

Address: ______________________________________________________

______________________________________________________

Telephone: ____________________________________________________

9. Communities served by airport, including population and distance to airport

by road. Community Population Distance (km)

___________________ ____________ ____________

___________________ ____________ ____________

___________________ ____________ ____________

___________________ ____________ ____________

10. Please circle all applicable to your airport.

PUBLIC UNPAVED DAY VFR REGISTERED

PRIVATE PAVED NIGHT IFR CERTIFIED

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11. Is the airport listed in The Canada Flight Supplement? _____ 12. Give a legal description of property on which the airport is located.

____________________________________________________________

____________________________________________________________

____________________________________________________________ 13. Does the local airport commission own the property on which the airport is

located? ____ yes _____ no 14. If the airport property is leased, please give details of lease including:

Length of Lease ______________________________________________

Expiry Date __________________________________________________

Rights of Renewal ____________________________________________

____________________________________________________________ 15. Please list details of existing facilities.

a. Geographic Coordinates: ____________°N _____________°W

b. Aerodrome elevation at highest point on airport: __________ feet above sea level.

c. RUNWAY

Magnetic Bearing ___________________

Dimension of Runway ___________________

Dimension of Graded Area ___________________

Dimension of Cleared Area Beyond Graded Area___________________

Nature of Runway Drainage ___________________

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d. TAXIWAYS

Dimensions of Taxiways ___________________

Nature of Taxiway Surface ___________________

e. AIRCRAFT PARKING RAMP

Dimensions of ramp ___________________

Nature of Ramp Surface ___________________

f. RUNWAY LIGHTING SYSTEMS

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

g. TAXIWAY LIGHTING SYSTEMS

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

h. WIND INDICATOR ___ Lighted ___ Unlighted

i. ROTATING BEACON (type)

_______________________________________________________________

j. TYPE OF MARKERS ON:

Runway ___________________

Taxiways ___________________

Ramps ___________________

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16. Please describe other airport facilities.

a. FIRE FIGHTING APPARATUS

_______________________________________________________

_______________________________________________________

b. FIRST AID EQUIPMENT

_______________________________________________________

_______________________________________________________

c. REFUELLING

_______________________________________________________

_______________________________________________________

d. ELECTRIC POWER

_______________________________________________________

_______________________________________________________

e. PASSENGER SHELTER

_______________________________________________________

_______________________________________________________

f. LAVATORY

_______________________________________________________

_______________________________________________________

g. TELEPHONE

_______________________________________________________ _______________________________________________________

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h. TRANSPORTATION TO NEAREST TOWN

_______________________________________________________

_______________________________________________________

I. ACCOMMODATION IN NEAREST TOWN _______________________________________________________

_______________________________________________________

17. BY-LAWS

State numbers of by-laws establishing the local airport commission and dates of passage in each participating municipality.

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

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18. APPLICATION

We, the duly authorized signing officers of the ______________________________

airport commission, make application to the Department of Infrastructure &

Transportation for an airport operation grant of $_________________ to be used to

cover the out-of-pocket costs of operation, maintenance and improvement of the

____________________________ airport.

(Signature) (Title)

____________________ _____________________

____________________ _____________________

____________________ _____________________

___________________, Manitoba _________________, 201___

(Town or Municipality)

19. To Whom It May Concern:

The ____________________ Airport Commission hereby authorizes the Department of Infrastructure & Transportation, or its duly authorized representatives, to enter onto the __________________________ Airport without notice for the purposes of inspecting all parts of the above mentioned Airport.

(Signature) (Title)

_______________________ ________________________

_______________________ ________________________

_______________________ ________________________

___________________________, Manitoba _________________, 201___ (Town or Municipality)