HomeMy WebLinkAbout3351 Eastbrook Dr - Miscellaneous - 09/22/2004A
Community Planning and
Building and Zoning Department
cifir of eollins
405976
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL BUILDING
PERMIT
I, (Print) I -TS AL,61-60 <vI7 as owner of record (property
Address) _3,15- f 1� Gi -<Ary 0 IC known as (name of
business) 5-� 5� /'o�rc �. 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 givingper mission 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
❑ I am giving permission for interior and exterior work. The scope of the work shall be limited to
(Property owner signature)
The foreg ng affi avit was acknowledged before
r (montth,year) by
therm fortfi.
Witness my hand and official seal.
My commission expires:
281 North College Avenue • P.O. Box 580 • Fort
the
0
,'r( for the purpose
rFtY ....
PV�I
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ANGELA
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80522-05W • ( AX (970)224-6134
My Commission Expires Nov. 20. 2005