HomeMy WebLinkAbout218 LINDEN ST - Filed P-PERMITS -City of �tColli� Planning, 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: �00..ID:itX\'{\._Q,,'(
Company: Id oie:n 0 -he:e\---ra:roo
Address of Sign Location: Z\ 5 L,od.:E:(\
City, State, Zip: :r----cx:1: Qo\\ \ D'S J C Q
Phone: q-::f-o-ZZ\· Z3YO
C_�"{ st 1�e:-\-8c)52Jd
Company Address if different than Sign Address: ______________________ _
City, State, Zip:----------------------------------
Contact Name : -�-, Contact Email: Ccn\-6,c.\-(i \, ndMS\t{?et-±9 &oocoe .. , ,._,_Mq(lf'?t, l,lU, I
Applicant agrees to submit with this permit application a minimum 8 1/2" x 11" dimensional drawing that U
illustrates the location of the proposed portable sign, obstruction(s) or other structure or amenities in the
public right-of-way. Applicant 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 permit 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 filed 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 eci conditions, r ictions and regulations that may be imposed by the City Engineer.
Engineering Approval: _______________ _ Date: ____________ _
Application Fee:$ _____________ _ Total Due:$ _________ _
Conditions: -----------------------------------
Permit Number: _____________ _ evised 04/15/2011
8/17/2023
10.00 10.00
Please be sure to maintain 7 ft of walkable space along the sidewalk
23-15044
Black Sparrow Inc
Dba: Linden Street Tattoo Company
218 Linden St
Fort Collins, CO 80524
07/31/2023
Zem Insurance Solutions
500 La Terraza Blvd. Suite #150
Escondido CA 92025
(888) 210-9641 (888) 210-9642
Evanston Insurance Company
A X 2DE2819 11/23/2022 11/23/2023
1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000
500
A Professional Liability
X 2DE2819 11/23/2022 12/15/2023
$500,000 Aggregate
$500,000 Per Claim
CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED PER THE ATTACHED POLICY FORMS.
The City of Fort Collins Engineering Dept
281 N College Ave
Fort Collins, CO 80524