HomeMy WebLinkAboutN R ADD - APPLICATIONS - 10/11/2010 (7)JAN 25 2011 Am 9:59
�o t Collins
_100��
'Planning, Development & Transportation
Engineering' Department
'PO Box 580 281 N College Ave.
Fort Collins,,CO 80524
970-221-660&P 970424-6134 F
Revocable 'Encroachment Permit for
Newspaperin the'Right-of-Way
(minimum of 51business days-required.for approval).
Applicant Name: 'F�G. n / 'I� �<r r Phone:, �"),O ` �13 5'—
Company: _ .Gc ker Alk hc, z ;, ✓ k
Address: f o:k .. qC_r .� S'dt, ;'.16 ,11
City, State, Zip: f2osikcta1' CO Toto
Dates of Encroachment: 1 year from application approval n/1
Location of Encroachment: _ ONS Wes+ [, Cnv f e- �, l • 1r� cc, r k
Contact Name: +k-", ID —Ir Contact Email: 6 �kk, .P- s '�. ® r4,�, (,,co•►,.
Applicant agrees to submit with this permit application a sketch, drawing or°plan.thatlllustrates the
location of.the;p5oposed outdoor eating area in thwpublic right-of-way. Applicant -must also submit -the
Indemnity Agreement,and a copy of the Certificate of Insurance with the City of'Fort Collins Engineering
Dept as Adi'dldona/ Insured..
This permit is non-transferable,'Is, personal to the Applicant and is non -assignable. Applicant agrees that any.
transfer of ownership, of the business holding the permit will,terminate this permit and require anew, applicatiornto
be filedi by the new owner.
Applicant has read this ,permit and agrees to abide by the current City of Fort Coilins'Standard. Specifications and'to
any such special conditions, restrictions and regulations that may be imposed by the City Engineer.
Applicants Signature:, ,Date: ex
Engineering ApprgVaC 1 , �, pir� Date: /O 1 [r // D
Application Fee: $. o Total Due: $ Z O
Conditions: 2A ", DPP` 60
Permit Number: F— ItOOO 1` �,
Revised 03115/2010