HomeMy WebLinkAbout2034 W Plum St - Miscellaneous/Owner Authorization - 03/03/2008Community Planning and Environmental Services
Building and Zoning Department
City of Fort Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) /�%%�✓- S�i� as owner of record (property
Address) Q 0 y- 2-0 36 IV. fGGfi'y1 known as (name of
business) o�O�j q-ZO 36 6& iO4V ► 'I6�if16075 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
❑ I am giving permission for interior work only The scope of the work shall be limited
to
I am giving permission for exterior work only The scope of the work shall be limited
to G L_
❑ I am giving permission for interior and exterior work The scope of the work shall be
limited to
( ope own Sig nat )
The for going affidavit was acknowledged before me on the day of
1 -
(month,year) by- - - (L
for the pu � ���e Q►�h,��,
Witness np han#QX4 jaI seat
My con ,rion o 8LAG
OF'CO%-O
ff
Permit�X d
Oc
.'2 4 7
W&e�� 01:4w�r
otary Public
(office use only)
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