HomeMy WebLinkAboutN R ADD - APPLICATIONS - 4/12/2011 (2)Elt�0a�(LNv✓
'ityof Planning,Development & Transportation
t"t C��h S Engineer n.g,'Department
Revocable Permit for Permit Number: NR
Newspaper i'n. the Right -of -Way Approval Date:
(minimum of-Tclays required for approval)
ApplicantName: /d,p•.A_ I Phone: 7�' �{-�2..'Yzf,(
Company: 'TcwD
Address: Po Ak �l Y
City, State, Zip:C
Dates of 'Encroachment: 1'year from application' approval /- Q
Location of. Encroachment: [
Type: ❑ Pay Free ❑ 'Newsrack
Applicant;agrees to submit;with,this;pennit:appllcation a sketch, drawing;, orplan that
illustrates the location, of the proposed;newsrack, obstruction(s), or,otherstructure, in the
public right-of=way.
This.permit is non -transferable, is personal; to the.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!fled'by the 'new owner:
Applicant -has read this permit and agrees tc abide,by•the,current :City of'FortlCollins Standard'
Specifications and Ito any such special con 'tions, restrictions, and regulations that may be iin
posed by the City°Engineer. — - - - —�
Applicant's Signature:. Date:
Engineering Approv � ��,. �...:— .Date::
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Application. Fee: Total'17ue $
Conditions:
Last'Revised 7/08'
281 North College,Avenue P.O. Box 580 Fort'Collins, CO 80522-0580 ,970.221.66051FAX 970.221.6378
www.fcgov.com/engineering ,