HomeMy WebLinkAbout3160 Rock Park Dr - Affidavits/Homeowner - 01/23/2014,
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/we,c�. �%`C/tiha5i`as owners) of record of the propertYlocated
At �� /�GY �� Forf Collins, Colorado hereby declare anri attFst
to the following`. (please check.orily`the`one'-that applies)
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`❑ I am/.we are acting on my/,our behalf for the purpose of obtaln'ing 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. l/we-have not personally constructed nay other new homes in the Fort Collins
city limits within the past 24-m6nth period:
am/we are acting on my/ourbe'half for the pu'rpose`of obtaining a building' peririWand personally
constructing an alteration or addition to my/our house: The house to be altered is on the above
property and is`my/our personal residence
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0 I am/we are acting on my/our behalf for the purpose of obtaining a building permit and personally
donstructing a`non'structural alteration to my/oiir attached single family dwelling unit Th'e`house
to be altered is my/eilr personal residence. 1 am awar'c that I/Ge c�,li;ci dq'any structural,
electrical plumbing ore mechariicaf work ar,d must dire contractors/subcontractors who are
currently licensed and insures with the City"of Fort Collins. `
,,am/we are personally performing all'of the work, brwill be continuously supervising unpaid.:v'oluntee,rs i
The work is directly related to the construction of the above referenced home, which is described more fully
on Permit Application (obtained from Building'and Zoning office)., I/we
understand that any persons) or agents) confracted to perform structural wood framing; plumbing, HVAC,
electrical work ,roofing or cast in place structural concrete wor *; MUST BE licensed contractors in:,
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accordance with the regulation of the City of Fort Collins.
l/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 Word " Order and a court summons
Sign in the presence bf Notary Public
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Owner Co-owner
The foregoing Affidavit Was acknowledged before me on this 2 J72o f
day
(month, year) by ,
Witness my hand and;ofkial seal r
., :MARGARET R.:CLANCY
NOTARY PUBLIC
My commission expires: STATE OF'COLORADO
s_ - :.NOTARY, ID.#.20134040425 '