HomeMy WebLinkAboutN R ADD - APPLICATIONS - 10/11/2010 (9)City of
Fort .Collins
Planning,Development & Transportation
Engineering Department, ,
PO Box 580 281 N College Ave
Fort Collins, CO 80524
970-221-6605 P 970424-6134 F
Revocable Encroachment Permit for
Newspaper in the Right -of -Way , `
(minimum of'5 business days required for approval) -
'Applicant Name: Phone:.,-fz — UR— &3S
Company: R�E1V1~61V\ �ou tt.:E 2h�
Address: b03oZ
City, State; Zip:
'Dates of Encroachment:.1 year from,application.approval
Location of'Encroachment: fILCr1dI fn�
Contact Name : _Ti 141M -� KLha 'Contact Email: '�T.Hq.�j, �w,s R' C �MA4L, c cA
Applicant.agrees to submit;with_this ,permit application a sketch, drawing or plan that.iliustrates°the • -
location of the.proposed outdoor eating area In the public, right-of�way. Applicant must,also submit.the
Indemnity Agreement and a copy of the Certificate of Insurance wkh the City of Fort Collins Engineering
Dept as Additional Insured:
This, permit is non -transferable, is personal to the,Applicankand'is.non=assignable. Applicant agrees -that any,
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 agrees to abide bythe current City of Fort Collins Standard Specifications and to
any such special conditions, restrictions and regulations that may ,be'Imposed ;by the City Engineer.
Applicants Signature: 1,� _ - --- — Date: to . 11/ [ D
i
roval; n -� ;���► Date:
$ D - Total Due: $
Conditions:
Permit Number: Etoao�
Revised 03/15/2010