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HomeMy WebLinkAbout216 Dartmouth Trl - Affidavits/Homeowner - 11/23/2009City Of Planning Development and Transportation PO Box 580 0rt Collins 281 N College Ave Ft Collins CO 80524 970 221 6760 phone 970 224 6134 fax HOMEOWNER AFFIDAVIT I/we JV<<A=�O as owner(s) of record of the property located At ;)l ( D&4* VA Tr( �� �- s�� �� c, Co WA Fort Collins Colorado hereby declare and attest to the following (please check only the one that applies) cool am/ we are acting on my/ our behalf for the purpose of obtaining a building permit and personally constructing my/our home The home to be constructed is on the above property and will be my/our primary residence I/we have not personally constructed nay other new homes in the Fort Collins city limits within the past 24-month period „t C/I am/we are acting on my/our behalf for the purpose of obtaining a building permit and personally constructing an alteration or addition to my/our house The house to be altered is on the above property and is my/our personal residence ❑ 1 am/we are acting on my/our behalf for the purpose of obtaining a building permit and personally constructing a non structural alteration to my/our attached single family dwelling unit The house to be altered is my/our personal residence I am aware that I/we cannot do any structural electrical plumbing ore mechanical work and must hire contractors/subcontractors who are currently licensed and insures with the City of Fort Collins I am/we are personally performing all of the work or will be continuously supervising unpaid volunteers The work is directly related str f tl a above referenced home which is described more fully i on Permit Application # (obtained from Building and Zoning office) I/we understand that any person(s) or agent(s) contrac ed to perform structural wood framing plumbing HVAC electrical work roofing or cast in place structural concrete work MUST BE licensed contractors in accordance with the regulation of the City of Fort Collins I/we understand that failure to comply with any of the above conditions may result in revocation of any permits associated with the above Permit Application number forfeiture of any fees that have been collected a Stop Word Order and a court summons Sign in the presence of Notary Public Owner Co owner The foregoing Affidavit was acknowledged before me on this �day of NtlV�.vH,l�e-i oZwl (m �Y z� MICHELLE L Witness my hand and officials MEIS N1 My commission expires MY COMMISSION EXPIRES Apra 15 2012 Notary Public