HomeMy WebLinkAbout2169 CHANDLER ST - Filed P-PERMITS -r-Cltyof T t t" S . r-Ort Collins ranspor a 10n erv1ces
� Engineering Department
Permit for Drive Approach/ Sidewalk in
Public Right-of-Way
(Minimum of 48 HOURS required for approval)
Permit Number: ----------1
Approval Date:
Fee Paid:
Applicant Name: /tnfbon1 IV\.01d·eC.JI\') DCompany: Prf>i-, C.o� Cf �J:f
Phone: C\ 10--8' 17 -DO 3 L Email: ,MC (OV\C( -t.+-e. (0 c0 Ho+wl0JI-rt/hAddress: I CJ .J '[ c-tJ !b.Q 5:YOContractor Name: f}/3l {C2rlC(l/? '
City, State, Zip: Etc ' (0 S-00 s= Phone: 0no -?fl 1✓00 '?�Property Owner's Name: k Work to be performed by (circle one): Property Owner Licensed ROW Contractor
Is the Contractor licensed and bonded with the City to do work in the public right-of-way? @ Yes □No
Pro ject Address: ..::;.�_\_\Q_°\__.___C.J_N\_O..-'�c\_,__\� __ s.\--=------'-�-{ ..\-__ c. _c::i _\_\ �_V'°l_<s.:.__:_,_c_o __ �_()_S_-_2_<;" _____ _
Existing Curb and Gutter D Hollywood LJ Rollover/ DriveoverLJ VerticalU Other (Please List)
Pr �osed Curb and Gutter Work
�
sed Sidewalk Work Access To LJ lns1all New Drive Approach Repair Exis1ing Sidewalk D Arterial Stree1 LJ Widen Existing Drive Approach Install New Sidewalk LJ Collec1or StreetLJ Repair Exis1ing w/out Alterations LJ Widen Existing Sidewalk LJ Pesiden1ial StreetU Close Existing Drive Approach U Repair or Install SNJ Chase LJ S1ate Highway:=o:::: Other (Please List)____ =:IT Othe'.�t) ____0 c-ther (List)
*TRAFFIC CONTROL PLAN SUBMITTED p{J YES □No
(Note: If work is on College Avenue. State Highway, arterial street. or collector street, a Traffic Control Plan must be submitted and approved by the Traffic
Engineer prior to the City Engineer's approval.)
**WILL TREES, SHRUBS OR OTHER VEGETATION BE DISTURBED □ YES�NO
(Note: If yes, a separate permit must be obtained from the City Forester at no additional charge.)
>{ Sidewalk/ Curb and Gutter (up to 100' -$.30/ foot additional)___ Sidewalk Chase (each) ___ Driveway up to 15' in width(s) ___ Additional footage in excess of 15' an additional charge of $0.30 per foot
@$25.00 _______ _@$25.00 _______ _@ $25.00 --------@ $0.30 _______ _@$40.00 _______ ____ Vehicular access to/from a State Highway*
/ :/.,. TOTAL FEET AMOUNT DUE $ ________ _
*Notwithstanding the foregoing, if any driveway is proposed to be constructed providing vehicular access to or from a State Highway, the permit fee for
such driveway shall be $40.00 regardless of width or use of the driveway.
Contractor agrees to provide the City of Fort Collins Engineering Department with an active or continuous surety bond in the amount of $10,000 issued by a surety company authorized to do business in the State of Colorado, upon application. If the property owner performs the work, a concrete license and bond is not required.
Applicant agrees to abide by the most current City of Fort Collins Standard Plans and Specifications and to such special conditions,restrictions, and regulations as may be imposed by the City Engineer. Applicant agrees to telep hone the Engineering InspectionRecorder at 221-6609, 24 HOURS PRIOR to any construction in the public right-of-way. Inspections are required befo·e and afterconcrete is placed. Fees are non-refun able.
CITY ENGINEER APPROVAL: _____________________ DATE: ________ _
EXPIRATION: 30 DAYS FROM DATE OF APPROVAL *CITY TRAFFIC ENGINEER APPROVAL:DATE: ________ _
.. CITY FORESTER APPROVAL: ____________________ DA TE: ________ _
LAST REVISED 11 /1/2010
281 North College Avenue• PO Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6605 • FAX (970) 221-3378 www.fcgov.com
Ken Zetye
Digitally signed by Ken Zetye
DN: CN=Ken Zetye, OU=Users and Groups, OU=Engineering, OU=PDT, DC=cs,
DC=city, DC=fcgov, DC=com
Date: 2022.09.29 14:07:29-06'00'
22-6021
9/29/2022
25.00