HomeMy WebLinkAboutN R ADD - APPLICATIONS - 2/26/2009 (5)Feb 2.0 09 04:25p
B., De1-aneu
,970, ,454 .SdIRB.
;p . 1
FO('tCOlU11S
Revocable ,Permit for.
Newspaper in the'Right-of-Way
(minimum or 7 ;days requhed for approval)
���Trans
:Permit Number: ,NR
Approval Date:
Applicant !Name: � 1-irn ed`�.ne1c3. ' phone: -I 20)
Company.
Address: 7C,O
City; State, Zip:
Dates of ,Encroachment: * 1. year from application approval
Location of Encroachmertt 9_ Basta Phsra _._.
y A, O
Type: O Pa 1 Free Newsrack
Applicant agreesto submit with this permitapplication asketch, drawing, or plan that
illustrates the location of;theproposed newsrack, obstruction(s). or other structure inthe
public right-of-way.
This permit is non4ransferabie. is personal tothe Appiicantand'is non -assignable: Appliant
aggrees thatany transfer of 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 agrees10 abide by the current, City of Fort.ColliwStandard
Specifications and'to any'such speciall conditions. restrictions; andi regulations,t t may be im-
posed by the City Engineer.
_;.s, Signatur
_ � ,. '"' " :.......... Date:: ��.
-Applicartt e: ----
Engineering Appal: ►~ - -
Application �Fee,i_ (�$ Total Due::$
Conditions: z9--5 / A J -e jQO (d
Date: Lr2 o g
Last Revised 7108'
281 North College AvenuwcP.O. Box 580 Fort`Collins, C0 80522-0580 o970.221.6605.FAX 970.221.6378
~.fcgov,.com/engineering,