HomeMy WebLinkAbout6132 S College Ave - Affidavits/Owner Authorization - 01/16/2014Fort 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
I, (Print) (—I—le( �Q/.fil �[� as owner of record (property
address) 6 J 7a S ie All known as (name of
business) JAB e g915-3 t5 e 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
2r-ra—m giving permission for interior and exterior work. The scope of the work shall
limited to :
z&,"aA
(Property owner name; please pant)
The foregoing affidavit was acknowledged before me o/n1 the & day of
(month, year) by
for the purposq4erein set forth.
Witness my hand and official seal.
My Commission expires: 0116 "pId-61(p
Permit #
Office use only
kc •/
My Commission Expires 01/22/2016