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Get NJ Form DA-5 2012

9-530-5270 APPLICATION FOR TEMPORARY AERONAUTICAL FACILITY LICENSE $10.00 $10.00 $10.00 $10.00 $10.00 AIRPORT BALLOONSPOT BLIMP MOORING MAST HELIPORT HELISTOP $20.00 $10.00 $15.00 $10.00 PARACHUTE DROP ZONE SEAPLANE BASE ULTRALIGHT REC FACILITY VERTIPORT T# APPLICANT INFORMATION NAME: ADDRESS: CITY: STATE: OFFICE PHONE: FAX: ZIP: HOME PHONE/CELL: EMAIL ADDRESS: APPLICANT REPRESENTATIVE INFORMATION (Person responsible for the conduct of the operation) NAME: ADDRESS: CITY: STATE: PHON.

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