HomeMy WebLinkAboutN R ADD - APPLICATIONS - 11/26/2009 (27)I
Cltvof
Plann
Fort Co Ins Engineering L)epartment
01
Revocable, Permit for, PermItNumben 'NR
-Way, •Approval Date.
NowspaperIn theRight of
(minimum of 7 days requkedlorapprovsQ
ApplIcant!Name:_1_) Phone:
Company: �
Address: 45i, Y_a-Z!;t AQ9 2DZ—
City, States, Zip:
Dates of Encro'schment: 1 year from application approval,
Locatl on,of Encroachment: 4 7
'Typw., 0 Pay
'Free
XNewsrack,
Applicant agrees to submit -wit i h this' .permit application a sketch, d1rawingi,or plan that
Illustrates,the locatiom of -the proposed newsrack, obstructlon(s),, or other structure In: the
public right-of-way.
This perrrilt,ig,non-transf6rable;Ispeisonalt6itheAppiloant!aridisnon-assign6ble.,Apollant
aggrees that any1ransferof ownership: of the busilness holding 4he, permit will'terminiate this permit
and require anew qppllcatlon-tobel filedi by the newowner.
Applicant has read!thIs permit and agrees totablde bylthe current City of Vort Collins Standard
Specifications and to any pdh special co res r and regulations thatmaY be,im
posed by the,Clty Engln r.
Applicarift Sign re: Date:
Eng1nderIng,Ap, va 'Date:
Application Fee: $ Total'Dw,
Conditions:
- r_YJPA_
L astRevIsed,7108
281 North CollegeAvenueR0Box 580 Fort Collins, CO 80522-0680,.976.221:6606f, FAX970221.8378
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WWW.fcgovicomfenglneering,