HomeMy WebLinkAbout140 W MOUNTAIN AVE - Filed P-PERMITS - (2)-\I· •
,. ... City of ktColll� Plannmg, Development & Transportation
Engineering Department
PO Box 580 281 N College Ave
Fort Collins, CO 80524
970-221-6605 P 970-224-6134 F
Revocable Encroachment Permit for
Portable Sign in the Right-of-Way
(minimum of 5 business days required for approval)
Applicant Name R1 (� (\\ 's Bi .W�W• * Dor, Company: :g,� A \s B\A(�fi> 4 Do�(
Address of Sign Location: l YD \,J, M.01.A.mtA., (\. l\v-c.
City, State, Zip: J1){:t Co1L'1S, Co BO 5Vi
Company Address if different than Sign Address: _____________________ _
City , State, Zip:--------------------------------
Contact Name: So..roa k'.11bo 'Pres.1}o Contact Email: '::fkmCJ.t'\ M boh:orV\.fCumc.epk Corr-,
Applicant agrees to submit with this permit application a minimum 81/2" x 11" dimensional drawing that illustrates the location of the prop osed portable sign, obstructlon(s) or other structure or amenities In the public right-of-way. Ap plicant must also submit the Indemnity Agreement and a copy of the Certificate of Insurance with the City of Fort Collins Engineering Dept as Additional Insured.
This pennit is non-transferable, is personal to the Applicant and 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 fi led by the new owner.
Applicant has read this permit and agrees to abide by the current City of Fort Collins Municipal Codes, Standard Specifications and any such special conditions, restrictions and regulations that may be imposed by the City Engineer.
Applicants Signature: &'-]?;.�Date: ---'-\_l-.-:;.
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Date: �
Total Due: $ /0 �
Conditions: _________________________________ _
evised 04/15/2011 Permit Number: ____________ _ 23-15006 Paid
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City of ktColll�
INDEMNITY AGREEMENT FOR
PORTABLE SIGN PERMITS The Permittee hereby convenants that it will indemnify and hold the Lessor harmless from all claims, demands, judgments, costs and expenses, including attorney's fees arising out of any accident or occurrence causing injury to any person or property whosoever or whatsoever due directly or indirectly to the issuance of the portable sign pennit and the placement and use of the permitted portable sign by the Permittee and its agents and employees, unless such accident or occurrence results from any tortuous misconduct or negligent act or omission on the part of the City, its agents and employees. J"J\$-\ � I b Dated this _ _,l.--=...:.... ___ day of Novern ff , 20 1-2. Permittee Name: £ I q [\\ \ 2 Bu 1 e <S i fb9s
By: _½..a.!'A.la..Llro ........ Q:>.L..JfJLUJb�fAc....._........u.fl'fr\n_,,.=41,LlfY''-'--------------Title: Crfcrhte. B (l\ rul D rem yAddress of Portable Sign: \Y� W • Mou..\l\{R�V\ A.'ft.
2022 BIG AL'S BURGERS & DOGS
140 W. Mountain Ave.
◄ street sign
ii 9' � ll 3' 1· I 2S I
A-ames n
24" Ide x 36 tall ,..
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