HomeMy WebLinkAbout1232 W Elizabeth St - Affidavits/Owner Authorization - 11/05/20133051L41b
Planning, Development & Transportation
dins 281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I,.(Pnnt) -as owner of record (property
address) I I z is - t 11 Z w - tff, -3 ZSi� �� known as (name of
business) Qw P-,% U) di AA.4 hereby authorize the
work fisted 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$ I am giving permission for interior work only. The scope of the work shall be
` limited to: Renovation of Ste C4 Including new interior walls. with electric outlets Minor HVAC
a I DA.
O I am giving permission for exterior work only. The scope of the work shall be
limited
O I am giving permission for interior and exterior work. The scope of the work shall
limited to
(ftpiertyMOW naim, PIWWPrh7t)
Thre� foregoing affidavit was
was admwledged before me on the `� dayof
r L
1 I ✓015 _ (month, year) by ``/_� N �1 Gt.YI t
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires:N�
Permit #
Ofte use only
NA
NotdryPubll
JENNIFER CZAPLEWSKI
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20074015356
"Co,mnWIw Exphes APriI 18, 2015