HomeMy WebLinkAbout1205 W Elizabeth St - Affidavits/Owner Authorization - 05/22/2013IL
City of
Fort Collins
Planning, Development & Transportation
281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
owner of record (property
.nown as (name of '
business) —TJ� WAS S f 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
limited to:
❑ 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
n
limited to
The foregoing affidavit was acknowledged before me on the A) A-"� - day of
�/�/ Ag 3 (month, year) by A14?409e.,
for thepurpose therein set forth.
Witness my hand and official seal.
My Commission expires:
Permit
Orrice use only
Notary Public
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