HomeMy WebLinkAbout123 N College Ave - Affidavits/Owner Authorization - 12/18/2012City Of Planning, Development & Transportation
Flirt Collins 281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
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I, (Print) R iAA a L. �l 1 „ I Y,"t d- 6leg j d�nl as owner of record (property
address) f 2 3 -N. CoIL$&-„Q C,,,,,da 170 known as (name of
business) C e s C e v% d o hereby authorize the
work listed below to be done on said property. I understand that such work will only be
performed contractors licensed by the City of Fort Collins.
❑ I am giving permission for interior work only. The scope of the work shall be
=In
❑ I am giving permission for exterior work only. The scope of the work shall be
limited
I am giving permission for interior and exterior work. The scope of the work shall be -
limited to0v\ S4vuc-'Lkv0 MoLifo,�
(Property owner signature)
1prr�Qvd L. AyvcLvsan—aEE
(Property owner name, please print)
The foregoing affidavit was acknowledged before me on the E) day of
12G I C90 1 �-- (month, year) by2.�ii ,
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: 3-��-�01
CG
Permit #
rice use only