HomeMy WebLinkAbout1031 Conifer St - Affidavits/Owner Authorization - 06/10/2002Community Planning and Environmental Services
Building and Zoning Department
City of Fort Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) CA Al % 0A—) CaN CC 6T" Afig :LTb as owner of record (property
Address) 103 1 COP FCA 57Xc l' known as (name of
business) CAA1 yOA) COVC64,i N4 C Ltd 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.
�q I am giving permission for interior work only. The scope of the work shall be limited
to D A Its C FZ OO R
❑ I am giving permission for exterior work only. The scope of the work shall be limited
to
❑ I am giving permission for interior and exterior work. The scope of the work shall be
limited to
! 1 I mkp JEA�
(Prop rty owner signature)
The foreoing affidavit was acknowledged before me on the /v-� day of
• lone (month,year) by �5 S j le.
for the purpose therin set forth.
Witness my hand and official seal.
My commission expires:�1-14165
Permit #
Notary Public
(office use only)
161 North l-ollege Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134