f-ldu-100landuseproposalsubmissionform-navcanada（6页）.docVIP

Land Use Proposal Submission Form Date Received by NAV CANADA ????? NC file N°./ Ref N° ????? TC File N° / Ref N° ????? General Information: Company/Owner Name: ????? Contact Person: ????? Address: ????? City: ????? Prov: Postal Code: ????? Tel: ????? Fax: ????? Email: ????? 24 Hour Emergency Number: ????? Applicant: ????? Contact Person: ????? Address: ????? City: ????? Prov: Postal Code: ????? Tel: ????? Fax: ????? Email: ????? 24 Hour Emergency Number: ????? Airport Authority?: ????? (If within 6 km of a lighted aerodrome) Airport Manager: ????? A