HomeMy WebLinkAbout618 Cherry St - Affidavits/Owner Agent - 06/30/1999Building & Zoning Dept. For Collins,CollegeAvenue,P.O.Box580
Fort CColorado 80522-0580
Community Planning and Environmental Services Phone: 970 221 6760 FAX: 970 224 6134
BUILDING OWNER OR BUILDING OWNER'S AGENT/
EMPLOYEE CONSTRUCTION AUTHORIZATION AFFIDAVIT
l/we, K A�
r (PLEASE PRINT)
as owner(s) of record of the property
located at: G � $ C- Ij e-A IQ Fort Collins, Colorado, hereby declare and attest
to the following:
)6—I am/we are acting on my/our behalf for the purpose of obtaining a building permit for minor alterations
to the building referenced above. I am/we are personally performing all of the work as described on
` permit/app # I- F' 2-2 ; or
❑ I/we do authorize
(Agent) to act on
my/our behalf for the purposes of obtaining a building permit for minor alterations to the building
referenced above. Said Agent will be personally performing all of the work as described on permit/app
I/we understand that the Agent named above is not a contractor and is mylour employee as defined by
Colorado law; or, is acting on mylour behalf without any fee, compensation, or trade in -kind for the
above work.
Further, I/we understand that payment of such fees or compensation for the above work, to any person
who is not my/our employee as prescribed by Colorado law, constitutes a "construction contract" and
violates the Contractor License provisions of the Fort Collins Code, and will result in revocation of the
above permit.
I/we acknowledge having read PjPM 57 and understand the limitations therein.
To"�,
V �` —
wner
STATE OF COLORADO )
.)ss.
COUNTY OF LARIMER )
The forego Affidavit was
19t?!jr by
Owner
Agent
before me this 30— day of `Ljt 4Le
Witness my hand and official seal.`t"rrl
My Commission expires: ate,'