HomeMy WebLinkAboutN R ADD - APPLICATIONS - 5/13/2009 (6)c,I:,:�ity Of— Planning,, Development & Transportation
1' ` Collins Engineering Department,
-Applicant N
Company:.
Revocable Permit for Permit Number: NR
News,paper in the Right -of -Way Approval Date:
(minimum -of T daywrequired forapproval) j
Phone'
-Address:
City,State, zip:1/7
I.YJ D.j w
Dates of Encroachment: ,1 year lipm:application approval
Location of Encroachment:
Type: ❑ Pay Free ❑ Newsrack
Applicant agrees to submit with thls.permitapplication a, sketch, drawing, or plan that
Illustrates the location c&the proposed newsrack, obstruction(s), or other structure in the
public rilght-of�way.
This,permit is non -transferable, Is personal tothe Applicant andis, 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 Cof Fort,Collins Standard
'Specifications and to any suc pedal condition rictions, and, regulations,that maybe im-
posed'by the City. Engineer
Applicant's Signature: Date:
Engineering .Appr al; Date:
Application Feed: $. Z 0 - Total Due: $� D '
Conditions:
Last. Revised 7/08
281 North, College.Avenue P.O. Box 580 oFort Collins, COi 80522-0580, i 970.221.6605,i FAX-970.221.6378
www.fcgov.comlengineering