HomeMy WebLinkAboutN R ADD - APPLICATIONS - 4/12/2011Revoca'blePermit for
Newspaper in, ;the Right -of -Way
(minlmunotTdays,required fonapproval)
Applicant Name: -%DID
Company: J✓6. V -/,2.,
& Trans
Permit Number: NR
Approval Date:
Phone: _ 70 - Y 7 Z Y2
Address: Pox!y
City, State,, Zip: G° `�''if,e2v ZZ
,Dates of Encroachment: 1 year from application. approval
L' ocation of Encroachment:
Type! El Pay ,Free 0 Newsrack
Applicant agrees to submit with this permit application a sketch, drawing, ouplamthat
illustrates the location of the proposed newsrack,. obstruction(s), or other;structure in the
public right-of-way.
Tihis;permit is non -transferable, is,personal to the Applicant and,is non -assignable. Appliant
aggrees•that anytransfer of ownership,of the'business holding the permit will'terminate this permit
and require a new,appiication to, be filed. by the new -owner.
Applicant'has read this;permit and agrees to abide by the current Cityof.Fort Collins Standard
Specifications sand to any such special conditions; restrictions, and regulations that imay'be ,im-
posed'bythe :City'Engineer.
Applicant's Signature: Date:
Engineering Approv, Date: y /�
Application Fee: Total Due:'$
Conditions:
LastRevised
28.1 North,College Avenue P.O. Box 58G,FortCollins. CO 80522=0580 ,970.221..6605 FAX 970.221.6378.
www.fcgov.com/engineering