HomeMy WebLinkAboutN R ADD - APPLICATIONS - 7/16/2010City Of
.-car Collins
JUL 1 I_V1Q HM'an
RevocablePermit for (Permit Number. NR,
Newspaper in the Right -of -Way Approvai',bate:
(minimum of, Tdays required for approval)
Applicant:Name:
Company: `
Address:
City, State, Zip:
.Dates of'Encroachment: 1, year from application approval
Location of;Encroachmentt _
Type: D�Pay Free
Phone: I -7 '` 02D -
❑ Newsrack4 goetef C-S
'
Applicant agrees to,submit with this,permitapplication 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, perrnit,is non -transferable, is personal'to the Applicant and, Is non -assignable: Appliant
aggrees that -any transferrof 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 co itions, restrictions, and regulations that may be im
posed by the City Engineer
Applicant's Signature:: Date: l
Engineering ApprOVal: Date:'
Application Fee ($ D ' o Total Due: $
Conditions:
Last Revised 7/08'
281 North College Avenue , P.O. 'Box 580 , Fort Collins, CO 80522-05801970.221.6605 .:FAX 970.221.6378
www.fcgov..com/engineering