Pointer Avionics skyhunter 406 - Page 251

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Form Approved
0.M.B. No.
2120-0018
0
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APPLICATION FOR
INSTRUCTIONS-Print or type. Do not wrjte in shaded areas; these are for FAA
..
use only. Submit original only to an authorized FAA Representative. If additional
US.Depatmerf'
AIRWORTHINESS
space is required. use an attachment. For special flight permits complete Sections
cOa1spou011Clh
CERTIFICATE
II and VI or VII as applicable.
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Adl1•11s1,a11011
1.REGISTRATION MARK
2.AIRCRAFT BUILDER"S
NAME(MakeJ
3. AIRCRAFT MODEL DESIGNATION
4.YR.MFR.
FAA\\haaas
5~
N82628
Bell
Helicopter Textron Can
ada 412 EP 1995
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a: ....
5. AIRCRAFT SERIAL NO.
6. ENGINE
BUILDER"S NAME (Make}
7. ENGINE MODEL DESIGNATION
50\000
u-
a: a:
PT6T-3D
-U
136106
Pratt & Whitney
CCI)
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8. NUMBER OF ENGINES
9. PROPELLER BUILDER'S NAME
(Make}
10. PROPELLER MODEL DESIGNATION I 11. AIRCRAFT IS (Check 11 appllcableJ
2
N/A N/A
Ix I IMPORT
APPLICATION
IS HEREBY MADE FOR: (Check applicable 1/emsJ
A, 11x
STANDARD AIRWORTHINESS CERTIFICATE (Indicate category} I I NORMAL
I UTILITY I
jACROBATICI x
TRANSPORT
I
!GLIDER
I I BALLOON
B
SPECIAL AIRWORTHINESS CERTIFICATE
(Ch~ck appropriate items}
"2
LIMITED
Q
1 CLASS I
I!!
••
PROVISIONAL (Indicate class}
2 CLASS II
...
Ill
:::,
'1
AGRICULTURE AND PEST CONTROL
2'
AERIAL SURVEYING I s I
I AERIAL ADVERTISING
0
Ill
a:
:a
RESTRICTED (Indicate operation(sJ to
•
FOREST (Wildlife conservat,onJ 5
PATROLLING
I• I
I WEATHER CONTROL
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be conducted}
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1
CARRIAGE OF CARGO
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OTHER (Specify}
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1
RESEARCH AND DEVELOPMENT
2:
AMATEUR BUILT
t•af
I EXHIBITION
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j:::
4
EXPERIMENTAL (Indicate operation(sJ
"
RACING
••
CREW TRAINING
I
I
I MKT. SURVEY
a:
to be conducted}
...
u
•
TO SHOW COMPLIANCE WITH FAR
::::
1
FERRY FLIGHT FOR REPAIRS. ALTERATIONS, MAINTENANCE OR STORAGE
SPECIAL FLIGHT PERMIT
(Indicate
2
EVACUATE FROM AREA OF IMPENDING DANGER
•
operation to be conducted, then
complete Section VI or VII as
$
OPERATION IN EXCESS OF MAXIMUM CERTIFICATED TAKE·OFF WEIGHT
D applicable on reverse side}
•
DELIVERING OR EXPORT
s
PRODUCTION FLIGHT TESTING
•
CUSTOMER DEMONSTRATION FLIGHTS
c
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MULTIPLE AIRWORTHINESS CERTIFICATE (Check ABOVE "Restricted Operation· and "Standard" or "Limited," as applicable.}
A. REGISTERED OWNER (As shown on certificate of aircraft registration}
IF DEALER, CHECK HERE
I
NAME
ADDRESS
BELL HELICOPTER TEXTRON,
INC.
P. 0. BOX 482
FORT WORTH, TX 76101
B. AIRCRAFT CERTIFICATION BASIS (Check applicable blocks and complete items as indicated}
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AIRCRAFT SPECIFICATION OR TYPE CERTIFICATE DATA SHEET (Give No.
AIRWORTHINESS DIRECTIVES (Check ii all applicable AD's complied w1/h and give
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x
and Revi$ion No.}
H4SW
Rev. 21
x
latestADNo.J
95
_
09
Issue
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AIRCRAFT LISTING (Give page number(s}}
SUPPLEMENTAL TYPE CERTIFICATE (List number of each STC incorporat-.1)
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C, AIRCRAFT OPERATION AND MAINTENANCE RECORDS
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CHECK IF RECORDS IN
TOTAL
AIRFRAME HOURS
I ·, EXPERIMENTAL ONLY (Enter hours flown si~ fast certificate
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COMPLIANCE WITH
a issued or ranew-.JJ .
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x
.417
30.1
s
FAR91.1*
D. CERTIFICATION - I hereby certify that I am the registered owner (or his agent) of the aircraft described above; that the aircraft is regislered with the Federal Aviation
Administration in accordance
with Section 501 of the Federal Aviation Act of 1958, and applicable Federal Aviation Regulations; and that the aircraft has been inspected and is
airworthy and eligible for Iha airworthiness certificate requested.
DATE OF APPLICATION
NAME ANO TITLE (Print or type}
SIGN~ K7. -1. ~
May 16,
1995
J.
R.
Swindell,
PA Engineer,
Flight
... .. .. ---.-.oLt.#
A. THE AIRCRAFT DESCRIBED ABOVE HAS BEEN INSPECTED ANO FOUND AIRWORTHY BY: (Complete this sec/ion only if FAR 21.183(d) applies)
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..
FAR PART 121 OR 127 CERTIFICATE HOLDER (Give
r:~:1
CERTIFICATED MECHANIC (Give
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CERTIFICATED REPAIR STATION (Gwe Certificate
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... ul=
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Certificate No.J
Certificate No.) ·
. No.)
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AIRCRAFT MANUFACTURER (Give name of firm}
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DATE
TITLE
SIGNATURE
(Check ALL applicable blocks in items A and BJ
x I THE CERTIFICATE REQUESTED
A. I find that the aircraft described in Section I or VII meets requirements for.
4
I AMENDMENT OR MODIFICATION OF CURRENT AIRWORTHINESS CERTIFICATE
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II. Inspection for a special flight permit under Section VII
FM INSPECTOR
FAA OESIGNEE
.::e
~~ ...
was conducted by:
CERTIFICATE HOLDER UNDER:
FAR65
I
I FAR 121, 127 or135j
IFAR145
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. .., ...
DATE
DISTRICT OFFICE
°lX:/l!:t_:::____
FAA INSPECTOR'S SIGNATURE
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May
16,
1995
FTW FSDO
4
Richard B.
Simmons DAR -37-AC-SW
.,
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FAA Form 8130-6 (6-86) SUPERSEDES PREVIOUS EDITION
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