HomeMy WebLinkAboutN R ADD - APPLICATIONS - 12/17/2009 (2)MKOF Planning Development & , �ransportal lon
t'callins Engineering Department
Revocable Permit for Permit Number:.tee
.--
Newspaper in the'Right-of-Way Approval Date:
(mInhow of 7 days.required for approvaq i
Applicant Name: , —Jo f ��'������ � _ .Phone:; C) - .7 6-
Company; VA5191 :Z�� �10
Address: �e2,t W. 1 % 11� AU�
City. state, Zip: kVfi&7- MIS _rkA2 , Go ee)23 �
Dates,of Encroachment: 1 year from:applicatlon approval
Location of Encroachment ' 1 0S, luL -4 G,g Gd
Type: _XPay ❑ -Free ❑ Newsrack
Applicant agrees to submit With .thls+permitapplication a. sketch,,drawing, or plan,that
Illustrates the location of the proposed newsrack, obstruction(s), or other structure In the
public right-of-way.
This,permit ismon-transferable, Is personal tothe Applicant,andas no"esignable. Appliant
aggrees4hat any transfer of ownership of the`business holding,the;permit will terminate this.permif
and -require a new application,to' be filed by the,newowner.
Applicant has read'this,permWand agrees4o abide by the current City of Fort Collins Standard
Specifications and to any suchspecialiconditions, restrictions, and regulations that may be lm=
:posed by the City.Engineer.
—ApplicanVe Signature �� Date:
l�
Engineering,Approv :
'Application Fee: $
Conditions:
Date:
Last Revised'7/08
281 North College Avenue i P.O. Box 680 iFort Collins, C010522-0580470.221.6605nFAX 970.221.6378'
www;fcgov.com/engineering