HomeMy WebLinkAboutN R ADD - APPLICATIONS - 4/9/2009 (3)City of Planning, Development & Transportation
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Engineering Department h�
Revocable Permit for Permit Number NR '
Newspaper in the Right -of -Way Approval Date: y'9�Dti
(minimum.of 7 days required for appmaq
Applicant Name: ���, , QrK,f Phone: ,u
Company. �1K S l-d 6� 1
Address: (� f
City, State, Zip:
Dates of Encroachment 1 year from application approval
Location ofEncroachment: 44 4
Type: ❑ Pay O'Free ❑ Newsrack
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Applicant agrees to submit with this permit application a sketch, drawing, or,plan that
illustrates theRmation 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 ownershipW,the business Wdinglthe,permit will terminate this permit
and require:a new.application toibe filed by the new,b'Wner.
Applicant has.read+this permit and agreesto abide by the cunent City offort Collins Standard
Specifications and to any such special conditions restrictions, and regulations that maybe im-.
,posed!,by the City Engineer.
Applicant's Signature: Date
Engineering Approval: ri., Date:
Application Fee: $ Total Due:, $ % 4
Conditions:
Last'Revised 7/08
281 North College Avenue.,iP.O:. Box 5801Fort,Collins, CO 80522-0580 i970:221.660 iFAX 970.221'.6378
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