HomeMy WebLinkAbout3665 John F Kennedy Pkwy - Affidavits/Owner Authorization - 02/04/2014� City of
Fort CoWns
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
I, (Print)as owner of record (property
address) c 3 G & S- F k known as (name of
business) _ �� �, h r n fo 1��42 9 hereby authorize the
work listed below to be done on said property. I understand that such work will only be
perfonned contractors licensed by the City of Fort Collins.
1 I am giving permission for interior work only. The scope of the work shall be
limited to: & rr a n ¢
❑ 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
14 491) " e�4 r.-K �e-h K e-kl
(Proper ownerslynature) Vrvpkto, owner name, Please print)
The foregoing affidavit was acknowledged before me on the q-w, day of
Fe.�rltia,rM , IQ ►`t (month, year) by lZ1u,s Gtzr i s1 u, so,
for the purpose theiein set forth.
Witness my hand and official seal. NOTARY PUBLIC
My Commission expires: ST�•� E 01 C:C 10RADO —'
MY CONNIS.tiCN EXPIRES 621'28/2016
Notary Public
Permit #
Of/ice use only