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HomeMy WebLinkAboutN R ADD - APPLICATIONS - 3/31/2010 (2)r r. . City of Fart CcAtl #S Revocable Permit for Newspaper in. the Right -of -Way (miniinum of 7 days requlmd forappmal) Applicant Name: ,Company: Address: 2-`00 0 City, state, zip: Dates of Encroachment: 1' year.from M o 4 HIO 00oo 0 3 R permit Number NR (Approval Date: -CLA-i Phone: 'Q J ® - Z-z- al - 0 ?O C) Le {MO V_A_ I QCA [ CCD '50-5�s, Location of Encroachment: �P rn. r ✓f GX, Type: ❑ Pay I Free ❑ Newsrack v r o�. ` �s`� ati���- l -v O\A_Ae : e� 39,E �l �i'�°'� . J Applicant agrees to submit with this perinWapplication a sketch, drawing, ouplan that Illustrates the, location, of the proposed newsrack, obstruction(s), or other structure in the public right-of-way. 1�,,;-�rn e r 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 anew application tobe 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 anysuc�special.condlb'ons,restrictions; and regulations thatmaybe im- posed Eby the CItyEng1heer ,{ Applicant's Signature: J Date: .Engineering Appr al: Application Fee: $ Conditions: i_ /IJ `d Q th 0 r Z: Date: Total "Due: $ 0 '/��� Cr U-P (� r �,l C-t' A t qf Ig r, / ns Va zee e I-" CAI a L Ir O dL a iLast Revised'?/08 281' North. College Avenuej P.O. Box 580 Fort Collins, CO 80522-0580,,970:221.6605,?FAX 970.221.6378 www:fcgov:com/engineering.