HomeMy WebLinkAbout314 E Mountain Ave - Miscellaneous/Owner Authorization - 01/24/2007Community Planning and Environmental Services
Building and Zoning Department
City of Fort Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) Pau. ' `/ate 4 rr as owner of record (property
Address) _ i— A/49J Aff It( ly L LC— known as (name of
business) E, Av'z . hereby authorize the work
listed below to be done on said property. I understand that such work will be
performed only by contractors licensed by the City of Fort Collins.
Xj I am giving permission for interior work only. The scope of the work shall be limited
❑ I am giving permission for exterior work only. The scope of the work shall be limited
to
❑ I am giving permission for interior and exterior work. The scope of the work shall be
limited to
(Property owner signature)
The foregoing affidavit was acknowledged before me on the c�'� I fx day of
a (month,year) by
for the purp e therin set forth.
Witness my hand and official seal.
My commission expires:
Notary Public
Permit #
(office use only)
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221° 6760 • FAX (970) 224-6134
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