HomeMy WebLinkAbout333 W Mountain Ave - Affidavits/Owner Authorization - 01/16/2010Community Planning and Enwronmenta/Serncses
Fort Collins Neighborhood & Building Services
281 N College Ave P O Box 580 Fort Collins CO 80522 0580 Voice 970 2216760 FAX 970 224 6134
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OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I (Print)
Address)
business)
BOHEMIAN MOUNTAIN LLC
262 E Mountain Avenue
BOHEMIAN MOUNTAIN LLC
as owner of record (property
known as (name of
hereby authorize the work
listed below to be done on said property I understand that such work will be
performed only by contractors licensed by the City of Fort Collins
xo I am giving permission for interior work only The scope of the work shall be limited
* 333 West Mountain Avenue Ft Collins CO
Demolish entire building structure
❑ I am giving permission for exterior work only The scope of the work shall be limited
to
o I am giving permission for interior and exterior work The scope of the work shall be
limited to
Aopepff o ner signature)
The foregoing affidavit was acknowledged before me on the _day of
!Q�" Q —10175 (month year) by
for the purpose ther set t forth
Witness my hand and official seal
My commission expire# Aft"Wt/t0//
olooOL68 -
Permit #
(office use only)
Notary Public
04
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