HomeMy WebLinkAboutN R ADD - APPLICATIONS - 11/26/2009 (7)city of
ort Coll��ns
Revocable Permit for.
N'ewspaper'in the, Right-ofMay
(mtnimum of 7'day; regd1md`forepprovan
El�o•o le w
;Permit'Number: NR "
'Approval. Date:
Applicant N me: OQ S Phone:
Company:
Address:O'/)"'�
clty,: state, zip: 0& e 2
Dates of Encroachment; 1 year from application approval
Location of'Encroachment:wma_"!- and ao (g, &g
Type: [7 Pay 'Qree )<Newsrack RbJOA- - Ar
Applicant agrees to submit with this permit application a sketch, drawing, or plawthat
11 lustratesil the location of the proposed newsrack,, obstruction(s), or other:structure in the
public right-of=way.
This permit isrnon-transferable, is personal to1he Appllcant,and !s non -assignable. Appiiant,
aggrees that any transfer of ownership of the business holding th&permit wlll terminate'this permit
,and require s new application! to be filed by the,nevowner.
Applicant has read this ipermit and agrees to•abide byth¤t City of'ForMollins Standard
Specifications and to,any sK h special co oft. , —reffi—MoR,j and regulations that may be im-
posed by'the�City 1~ngin r.
Appi-Icanfs:Sign re Date:
1.
Engineering,Appro a . r Date:
Application Fee: $ Total Duel
Conditions:
Last Revised 7108
281, North College Avenue rP O: Box 880 iFort Collins, CO 80522-0580470.220605 iFAX-970.221.6378
ww0cgovxom/engineering