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UHU> r <br />�aa <br />Hugo City Hall, 14669 Fitzgerald Avenue North, Hugo, MN 55038 — Phone (651) 762-6300 — FAX (651) 426-2859 <br />Application Fee: $75.00 <br />PAIDS <br />APPLICANT <br />Name:/ <br />Address: 0 <br />Phon &,A FAX: Email: V\ <br />_ <br />V\Ics <br />Signature: Date: L4-1—� <br />FVFNT INFORMATION <br />Addre <br />Date: <br />PROPERTY OWNER/MANAGER <br />— - i , <br />Name: \�`/�1 V(�� <br />Address: l� U <br />PhoneCpc�)p �U� � FAX:A �� Email: <br />11 Signatur yr� w��—< v Date: �� <br />DESCRIPTION OF EVENT <br />Please review the items on the check list on the back of the application for information that is required to make this application <br />complete. If there is not enough room below to describe the event please submit on a separate sheet of paper. <br />cd oL c{v� <br />City Council Approval nate taerK wgnaxure <br />❑ Yes ❑ No ❑ Yes with Conditions <br />Conditions <br />