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Pre-Determined Landing Zone Application
Agency Name
Landing Zone Name
City
State
Illinois
Wisconsin
County
Major Cross Streets/Intersections
Dispatch Phone Number
Ground Contact Frequency
Lat/Long (in degrees, minutes, seconds)
Landing Zone (i.e. physical description)
Is Landing Zone
Paved
Unpaved
Hazards/Obstructions
Remarks
Name of Person Submitting this PDLZ Form
Date (DD/MM/YYYY)