The Civil Aviation (Certification, Licensing and Registration of Aerodromes) Regulations, 2024

1. PARTICULARS OF APPLICATION: a. Name / Title in full: b. Permanent Address: c. Telephone: d. Fax: e. E-mail: Physical Address: f. g. Residential Address: h. Occupation: cellural phone telecommunication

2. PARTICULARS OF APPLICANTS REPRESENTATIVE: a. Name / Title in full: b. Permanent Address: c. Telephone: d. Fax: e. E-mail: f. Physical Address: g. Residential Address: h. Occupation:

3. NATURE OF PROPOSAL: 95 Civil Aviation (Certification, Licensing and Registration of Aerodromes) GN. NO.5 (Contd.) a. Type: New construction b. Class: Permanent (Duration ………12….. months) c. Work schedule dates: Start … End ….

4. COMPLETE DESCRIPTION OF STRUCTURE: (a) Include effective radiated power and assigned frequency of all existing proposed or modified AM, FM, TV or mobile telephone transmitting stations utilizing this structure 400 watts 900 MHZ frequencies 1800 MHZ frequencies (b) Include size and configuration of power transmission lines and their supporting (c) towers in the vicinity of TCAA facilities and airports. Include information showing site orientation, dimensions and construction materials of the proposed structure. Antennae orientation Antennae height Construction material:

5. LOCATION OF STRUCTURE: (a) Coordinates (To the nearest second) (b) Nearest city, town or village: (c) Distance and direction to 5 (b): (d) Name of nearest airport: (e) Distance from structure to nearest point of nearest runway at the airport: (f) Direction from structure to airport: (g) Elevation of the mid point of the runway at the airport (h) Description of location of site with respect to highways, streets, airports, prominent terrain features, existing structures, etc. Attached a survey map of scale 1:50,000 showing the relationship of construction site to nearest airport(s).

6. HEIGHT AND ELEVATION (To the nearest foot): (a) Elevation of site above mean sea level: (b) Height of structure including all appurtenances and lighting above ground or water: (c) Overall height above mean sea level:

7. LOCAL GOVERNMENT APPROVAL (a) Before submitting this application, the authorities, as indicated below, should be consulted and, if appropriate, their approvals obtained. Please give details. District/ Regional Land Planning Authority, Port and Harbour Authority (in case of water structure). Village, District and Regional Government Authorities of the area of structure location. (Attached documentary evidence). Name and address of Authority Date and reference of Approval (b) Have any of the authorities mentioned above raised any objection to the proposed use of the site as an aerodrome? If the answer is YES please state the authority concerned. 96 Civil Aviation (Certification, Licensing and Registration of Aerodromes) GN. NO.5 (Contd.) CERTIFICATE In hereby certify that all of the above statements made by me are true, complete and correct to the best of my knowledge. In addition, I agree to obstruction mark and/or light the structure in accordance with established marking and lighting standards. Name and title of person filing the notice: Signature …………………………………… Date: ……………………………………….. Dodoma, 15th December, 2023 MAKAME M. MBARAWA, Minister for Transport 97