HomeMy WebLinkAbout1600 Specht Point Rd - Affidavits/Owner Authorization - 05/09/2003CGntinunity Planning and Environmental 5ercices
1 -wilding and Zoning Department
City of Fart Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) Lgy :.4 00 , as owner of record (property
Address) SP'04(7— /ff De known as (name of
business) 141E W,10, 1C-" )UdJD3 0tv • 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.
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
to
o I am giving permission for interior and exterior work. The scope of the work shall be
limited to
(Property own r signature)
Theforegoing affidavit was acknowledged before me on the day of
6t,t i , 0 00 (month,year) by a e- K
for the purlposO t erin set forth.
Witness my hand and official seal.
My commission expires: ` I 5V,62 Q a 00 Lo
Ou�
BO 3025 3.8
Permit #
(office use only)
Notary Public
O,�p,RY
DEBI L.
GOOD
OF COv
MY C0MMiSWn Expires Nov. 20. 200P
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134