HomeMy WebLinkAbout123 N College Ave - Miscellaneous/Owner Authorization - 07/26/2006Community Planning and Environmental Services
Fort Collins Neighborhood & Building Services
CiNoi wncoums 281 N. College Ave., P.O. Box 580; Fort Collins, CO 80522-0580; V 'ce: 970 2216760 F : 970 224 6134
806036,
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) DAWA OCY-ps By as owner of record (property
Address) l tS haf-R+ CoLLfd?E , Su rl-r_ 340 known as (name of
Mnarl �'
business) bkfE>151 5HV"A,L) UE'- 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 I am giving permission for interior 'Nork only. The scope of the work shall be limited
t-XPAnIs1be4 bF (;}Xt`;%nm4 6FPfcE 5eAeF-
❑ 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 o ner signature)
The forirlg affidavit was acknowledged before me on the 2�0 Ada of
t4. �4 . 200to (month,year) by ya:: , ,45=
for the purposfe t erin set forth.
Witness my hand and official seal.
My commission expires: q/1-2 Id 1
Permit #
(office use only)