HomeMy WebLinkAbout7127 Ranger Dr - Affidavits/Homeowner - 04/24/2007Community Planning and Environmental Services
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HOMEOWNER/BUILDER AFFIDAVIT
City of Fort Collins
I/we, BO r\n i 2 t V-0 M v x as owner(s) of record of the property located
(please pri
at: -% i -7 1� a n a er Q , o Fort Collins, Colorado, hereby declare and attest to
.(please print)
the following: (please check A. B or C. whichever applies)
❑ A. I_ 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 any other new home in Fort
Collins city limits within the past 24-month period.
B. 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 home. The home to be altered is on the
above property and is my/our personal residence.
❑ C. I 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
home to be altered is my personal residence. I am aware that I/we cannot do any structural,
electrical, plumbing, or mechanical work and must hire contractors/subcontractors who are
currently licensed 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 to the construction of the above referenced home, which is described more
fully on Permit Applicati (obtained from Building and Zoning Office).
I/we understand that anDEUrf o a a d to perform structural wood -framing, plumbing,
HVAC, electrical work, roofing or cast-in-p ace s ru ral 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 Work Order and a court summons.
Sign in the presence of a Notary Public
Owner Owner
Affidavit was acknowledged before me on this day of
V) o (month, year)by '_B0NN i :y r[.obt "Z
Witness my hand and
My commission
NE Cy
tits'eal 1<,p 0
01ARy
PUB
o
Notary �bl�
281 North College
ox 580 • Fort Collins, CO 80522-0580
-6760 • FAX (970) 224-6134