HomeMy WebLinkAbout700 W MOUNTAIN AVE - Filed P-PERMITS - (3)Engineering Department
281 North College Avenue
P.O. Box 580
Fort Collins, CO 80522.0580
970.221.6605
970.221.6378 - fax
fcgov.com/engineering
Planning, Development & Transportation
REVOCABLE ENCROACHMENT PERMIT APPLICATION
in the Public Right-of-Way
(Minimum of 5 business days required for approval)
ENCROACHMENT SUBMITTAL INFO: All submittals MUST include the following with this application:
1.A sketch plan that shows the proposed location(s) of the encroachment(s) and locations of the property line(s),
sidewalk(s), and street(s). A licensed surveyor may be required to accurately locate property boundary(s).
2.Applicants for an encroachment permit that will occupy any parking spaces in the downtown area must notify the City
of Fort Collins Parking Services Department, at 215 N. Mason Street, (970) 221-6617.
Applicant Name: Phone:
Company: Email:
Address: City: State: Zip:
Sub-Contractor: Phone:
Address: City: State: Zip:
Location of Encroachment (Address):
Type of Right-of-way Impacted: Street Alley Sidewalk Other:
Purpose of Encroachment:
Dates of Encroachment: From: / / To: / / or Until Revoked (permanent type items)
This permit is non-transferable, is personal to the Applicant and is non-assignable. Applicant agrees that any
transfer of ownership of the business holding the permit will terminate this permit and require a new application to be
filed by the new owner.
Applicant has read this permit and agrees to abide by the City of Fort Collins Municipal Codes, Standard Plans and
Specifications and to such special conditions, restrictions, and regulations as may be imposed by the Engineering Department.
APPLICANT SIGNATURE: DATE:
Encroachment Permit Type: Minor Major
Permit Fees: Application Fee: $ Inspection Fee: $Total Due: $
Conditions:
CITY OF FORT COLLINS APPROVAL:
Revised: 10/15/2018
DATE:
Permit Number:
Dayna Larson 480-332-9149
Traditional Chinese Medical Clinic dayna@tcmclinic.org
700 W Mountain (parked on Loomis)Fort Collins CO 80521
Fort Collins Mobile Storage
700 W Mountain Ave and 111 N Loomis Ave
Temporary shipping container for clinic storage due to damage
Dayna Larson
11/9/21
10.00 10.00 20.00
Ryan Boehle 6/15/2022
22-9047
6/16/2022 to 8/31/2022