HomeMy WebLinkAbout3209 Coneflower Ct - Miscellaneous - 11/07/2000Building &Zoning
Dept,
281 N. College Avenue, P.O. Box 580
Fort Collins,
Community Planning and Environmental Services
Colorado 80522-0580
Phone: 970 2216760 FAX: 970 224 6134
HOME OWNER —BUILDER AFFIDAVIT
(PLEASE PRIM)
IM
as owner(s) of record of the property
located at: 3ao9 Corgileu r C f Fort Collins, Colorado, hereby declare and attest
to the following:
1. 1 am/we are acting on my/our behalf for the purpose of obtaining a building permit for the construction
or alteraltion of my/our home. The home to be constructed or altered is on the above property and
is my/our personal residence.
2. 1 am/we are personally performing all of the work, or supervising unpaid volunteers or "employees" (see
PPM 58 attached) who might be assisting with any of the work related to the construction of the above -
referenced home, which is described more fully on Permit Application No. (obtain from
Building & Zoning Office). 8001677
ast
3, I/we have not personally constructed any other new home within the p12-month penoZt.
4. I/we understand that any persons or agents contracted to perform structural framing, plumbing, HVAC,
electrical work, or roofing, MUST BE licensed contractors in accordance with the regulations of Fort
Collins.
5. I/we understand that failure to comply with any of the above conditions may result in revocation of any
permits associated with the above Application Number, and forfeiture of any fees that have been
collected.
Owner
STATE OF COLORADO )
)SS.
COUNTY OF LARIMER )
The foregoing Affidavit was acknowledged before me this L— day off Q�iS
�G byOr( _BCeTy(5®C_K�,
Witness my hand and official seal.
My Commission expires:
/ G / ' Cam!
Tres November 10, 2002 '� '' �-
Myromm�slonEx► ✓ Notary i,gblic