HomeMy WebLinkAboutN R ADD - APPLICATIONS - 7/9/2009 (4)Cil:$�#
F®t Collins
Revocable Permit for
-per RW'Newspap=ay
i (minimum of 7 days required fouapproval)
PermlMumber .NR
.Approval Date:
Applicant Name: J1 11 VVUSIS Phone: -
Company:. co-1 of, f 0vt co. a[K� l i' 6ye_aT11`0rt--.
Address: V5 N. M4soyi,,3Vd, rj00+_ PG:.box 15�o
City, state; zip: _ 0V co S co Alit C 2
Dates of Encroachment: 1 year from application approval
"Location of Encroachment: J tUiGi
Type: _ . ay Free O Newsrack
Applicant agrees to submit with this permit application a sketch; drawing, or planthat
Illustrates the location of the proposed ,newsrack, obstruction(s), or other structure in,the
public right-of-way.
This)permit:is nontransferable, is personal,to the -Applicant and Is,non-assignable. Appliant
aggrees that any transfer of ownership. of the business holding thelpermit will terminate this permit
and: require a.new applicatiorn to -be filed by the newowner.
Applicant has read this permit and agrees to abide by the current City of`t=ort Collins Standard
Specifications and to anysuch.special conditions, restrictions, and,regulationsdhat maybe im-
posed,bythe City Engineer.
.�Yts
Applicant's .5ig�aturet : ` Date:._ --
Engineering APpro Ya " Date:
Application Fee: / Q - m` Total Due:' $ �/
Conditions:
Last. Revised!7/08
281- North College Avenue P.O. Box 580 . Fort Collins, CO 80522-0580 , 970:221.6605 . FAX 970.221.6378
www.fcgov.com/engineed'ng