HomeMy WebLinkAboutN R ADD - APPLICATIONS - 7/9/2009 (5)Cityf--of Planning,,.0.evelopment & Transportation
Fort Collins Engineering. Department
Revocable Permit for :Permit Number VIR
Newspaper in the :R�i,g'ht-of-Way Approval Date:
(minimum of Z days,raqulred!for approval)
Applicant Name: �1 V(atU81.5 Phone: 771 - 19>5. b
Company: Cih 6f, Cp WtA4a 1\ {C�i
Address: 215 N. MaSo`1, 3V'd F100KI lea �<�x _J9C
City, State, Zip: , r 6y4 G.tli h s CC Fit 517
Dates of Encroachments 1 year-fromt�a�pplication approval
Location of Encroachment: ___ge )g n 5
Type: ay P�Free 0 Newsrack
Applicant agrees to submit°with this permit application a sketch, drawing, or plan that
Illustrates the location of the.proposed newsrack, obstruction(s), or other structu reinthe
public right-of-way.
This;permltls.non-transferable, is personal to1he.Applicant and is 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 flied by the new,owner.
Appiicant:has read' this. permit and�agrees to abide by the current City,of Fort Collins Standard
Specifications and to any such special conditions, restrictions, and regulations that may im-
posed by the CIty,Engineer!
APPlicant's,Signature: f•`t��1 Dater'
i
EngineeringA'
Dater
Applications Fee: $ 4 D "x Total Due:
'Conditions: . .
Last Revised;7/08
281 North College Avenue.., P.O. Box 580i,Fort Collins, CO 80522.0580,!97012.1.66051FAX 970.221.6378
www.fcgov.com/engineering