No certificate may be Issued unless a completed application form has been received (14 C.F.R. 91. 101. and 106). 

# 0 US Department of Transportation Federal Aviation Administration 

## APPLICATION FOR CERTIFICATE OF WAIVER OR AUTHORIZATION From Approved : 

### O. M. B. No. 2120-0027 08/31/2008 APPLICANTS - DO NOT USE THESE SPACES Region 

# I Date Action OApproved 

# 0 Disapproved - "Explain under "Remarks " Signature of authorized FAA representative 

### INSTRUCTIONS Submit this application in triplicate 

### (3) to any FAA Flight fighting equipment. The applicant may also wish to submit Standards district office. photographs and scale diagrams as supplemental material to assist in the FAA's evaluation of a particular site . Applicants requesting a Certificate of Waiver or Authoriza- Application for a Certificate of Waiver or Authorization must tion for an aviation event must complete ail the applicable be submitted 

### 45 days prior to the requested date of the items on this form and attach a properly marked 

### 7.5 series event. Topographic Quadrangle Map(s) , published by the U . S . Geological Survey (scale 

### 1:24,000) , of the proposed opera!- Applicants requesting a Certificate of Waiver or Authorizaing area . The map(s) must include scale depictions of the lion for activities other than an aviation event will complete flightlines , showiines , race courses, and the location of the items 

### 1 through 

### 10 only and the certification , item 

### 17, on the air event control point, Police dispatch , ambulance , and fire reverse. 1. Name of organization 2. Name of responsible person 

### ADVANCED AERIAL CINEMATOGRAPHY LLC LANEWOODER 3. Permanent House number and street or route number City State and ZIP code Telephone No.

mailing 

### 5909 CHATHAM COURT TUCKER GA, 

### 30084 4049198430 address 4. S late whether the applicant or any of its principal officers/owners has an application for waiv er pending at any other office of the FAA NO 5 . Statewhethe rthe applicant or any of its principal office r s owners has ever had n sapplication for waiver denied . or whether the FAA has ever withdrawn awaiv e rfrom the applicant or any of its principal officers/owners. NO 6. FAR section and number to be waived 

### 14 C.F.R. 91.119 (b) and 

### (c). 7. Detailed description of proposed operation (Attach supplement ifneeded) CLOSED-SET AERIAL FILMING FOR THE FILM & TELEVISION INDUSTRIES .

ts . Area or operatton (Location , altitudes. etc.) UNITED STATES OF AMERICA AND IrS TERRITORIES. 9a . Beginning (Date and hour) b. Ending (Date and houtj 

### 05/04/2015 00:01:00 05/04/2017 00:01:00 10 . Aircraft Pilot's Name Certificate number Home address make and model and rating

**(Street ity**  **,** State) (a) (b) (c) Cinestar 8 HL, MikroKopter FC LaneWooder NA 5909 Chatham C o urt, Tucke r. GA Cinestar 8 HL, MikroKopter FC West Chambless NA 1045 Kentucky A v enue NE , Atlanta , GA

FAA Form 7711 -2 (8-08) Supersedes Previous Ed ition

# .... ITEMS 11 THROUGH 16 TO BE FILLED OUTFOR AIR SHOW/AIR RACE WAIVER REQUESTS ONLY. 11 . The air event will be sponsored by: 12 . Permanent House number and street or route number mailing City State and ZIP code Telephone No. address 13. Policing (Describe provisions to be made forpolicing the event) Policing and security will be planned and coordinated with film production officials per the requirements in our MPTOM, and any other provisions required by the location(s) and public safety officials involved . Agreed upon policing/security plans will be in place before any UAV operation will occur. 14. Emergency facilities (Mark all that will be available at time andplace ofairevent . ) 

## 0 Physician 

## 0 Fire truck 

## liD Other - Specify Ranges from Paramedic to mutiple 

## D Ambulance 

## 0 Crash wagon EMS personnel/equip. depending on action involved. 15. Air Traffic control (Describe methodofcontrolling traffic. including provision forarrival and deparlure ofscheduledaircraft.)

16. Schedule of Events (include arrival and departure ofscheduled aircraft andother periods the airportmaybe open.) Hour Date Event (a) (b) (c) Sunrise to Entire range All operation will be simple movements that can be achieved by a multi-rotor RC helicopter, such as rising, Sunset listed in descending, and moving horizontally through airspace. All operation will be line-of-sight only, and no stunts or Section 9 inverted flying will be conducted. Maximum operation altitude is 400 feet AGL, maximum flight speed is 40 above. mph.

Ifsufficientspace is not available , the entire schedule ofevents maybe submitted on separate sheets , in the order andmannerindicatedabove. PleaseRe? The undersigned applicant accepts full responsibility for the strict observance of the terms of the Certificate of Waiver or Authorization, and understands that the authorization contained in such certificate will be strictly limited to the above described operation. 17. Certification- I CERTIFY that the foregoing statements are true . Date Signature of Applicant 05

/02/2015



# -;:;?~ **~ ~**  

# --cRemarl<s

FAA Form 

### n11-2 ( 8-08) Supersedes Previous Edition