HomeMy WebLinkAbout155 E Boardwalk Dr - Affidavits/Owner Authorization - 11/15/2013_Uty Ot Planning, Development & Transportation
-ort Collins 281 N. College Ave
Fort Collins, CO 80524
G ;/ PhoneN970-416-2740 Fax 224-6134
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BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) µs�7!✓ ///L/err ko,✓ ,/4 kgxc'/as owner of record (property
address) known as (name of
business) XVrr0J LG C- 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
v limited to: _ a sfa � t" of�.a /Psi✓oe,.H .
❑ 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
limited to :
(Property owner name, please print)
The foregoing affidavit was acknowledged before me onthe�5 day of
NOVCsy1l�hPD� (month, year) by .T',-7ii 14. ale i✓iso
for the purpose therein set forth.
Witness my hand and official s
'O
My Commission expires:
z:
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Permit #
Office use only