HomeMy WebLinkAboutN R ADD - APPLICATIONS - 11/26/2009 (20)_...............:.._........:............_.:........................._............_........_................_..........:...:................:...._........._...._...........:......_._..._............._......._..__..........................................................-_._-----.....
City of ( Planning, Development & Trans ortatlon
Fort Cottins „ Engineering Department
OqOOa47:MtD
:RevocablePermit for Permit Number: NR
Newspaper In, the Eight -of -Way' 'Approva[06te! -
(mintmum of Tdays'requlreMor approvaq
Applicant Name:Phone: _765'�,%
Company: /f �tOfU1 am Muld
Address:' Zr d'r""�
City$ State, zip: , 09@' �'l t C� �
Dates,of Encroachment: 1 year from, application! approval
Location of'Encroachment:tf3 d s'Zt-
Type: o Pay Free tKNewsrack
Applioantagrees to submit with thispermltappiication, a sketch, drawing, or plan that
illustrates, the location of the proposed newsrack,; obstruction(s), or other structure to the
1public 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,permlt
and. require a new application to be filed by the new owner.
Applicant has read, this permit and agrees to abide by the current City of Fort Colllns,Standard
Specifications and to any is ch speclal,co ; res'fri8t , and regulations that maybe Im-
posed by the City Engin r.
/7�'/'r lay
App4cant's Sign? reDate
Engindering App Date:
Application Fee: $ Total Due: $'
Conditions:
,LasfRevised 7108
281 'North College Avenue i P.O, Box 580 Fort Collins, CO 80522-0680 , 970.2216605 FAX 970.221.6378
www.fcgov.com1angineering�