HomeMy WebLinkAboutN R ADD - APPLICATIONS - 7/22/2008 (29)City of Fort Collins
Revocable Permit for
Newspaper in the Right -of -Way
(minimum of 7 days required for approval)
Planning, Devel
& Tra
Permit Number: N
Approval Date:
Applicant Name: S!-, e 1; 1) M N ♦ tr Phone: q 70 — 4q ,3_ a 5 60
Company:
Address:
City, State, Zip: �:_Ofz f^ W hN S
Dates of Encroachment: 1 year from, application approval
Location of Encroachment:
Type: ❑ Pay $Free ❑ a C) IV n/ ) (IS O /N,
Applicant agrees to submit with this permit application a sketch, drawing, or plan that
illustrates the location of the proposed newsrack, obstruction(s), or other structure in the
public right-of-way.
This permit is non -transferable, is personal to the Applicant and is non -assignable. Appliant
aggrees 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 current City of Fort Collins Standard
Specifications and to any such special conditions, restrictions, and regulations that may be im-
posed by the City Engineer..yy�� � �y (?
Applicant's Signature: t5� f of ,n�cv Date: 07'c� 0 8
Engineering Approval: Date: C . « .
Application Fee: $� Total Due: $ �—
Conditions:
Last Revised 7/08
281 North College Avenue , P.O. Box 580 Fort Collins, CO 80522-0580 1 970.221:6605 1 FAX 970.221.6378
www.fcgov.com/engineering