HomeMy WebLinkAbout7245 Fort Morgan Dr - Affidavits/Homeowner - 07/06/2009Community Planning,and Environmental Services
Building and Zoning Department:. `
HOMEOWNER/BUILDER AFFIDAVIT
City' of Fort Collins,. 3:7
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I/we,. �70_Ott WaIP 1--W00U5 as owner(s) of record. of the property located
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at kVll Fort Collins, Colorado, hereby` declare and attest to
(please `print)
the following` (please check A, B orC, whichevera)qolies)
o A. I am/ we are acting on my/our behalf for the purpose of obtaining a building permit and
personally, constructing my/our home. The home to be constructed. is. on the above property and
will be, my/our primary residence.,: I/we have not personally constructed any other new -home -in Fort
Collins city limits within the past 24-month period:.
B. I am/we are acting on my/our behalf for the purpose of obtaining a: building permit and
personally constructing an alteration or addition .to my/our home. The home to be altered is.on the
above. property and is my/our personal residence.
o C. I am/we are acting on my/our behalf for the purpose of obtaining a building permit.and
personally constructing a non-structural alteration to my/our attached single-family dwelling
unit.. The home to be altered is our personal residence. I am aware that I/we cannot do any
structural, electrical, plumbing or mechanical work and must hire contractors/subcontractors who
are currently licensed with the City of Fort Collins.
I am/we are personally performing all of the work, or will be continuously supervising unpaid volunteers.
The work is directly related to the construction of the above referenced home, which is described more
fully, on- Permit. Application # (obtained from. Building and Zoning
Office). I/we understand that any persons or agents contracted to perform structural wood7framing,
plumbing, HVAC, electrical work, roofing or cast -in -place structural concrete work, MUST BE licensed
contractors in accordance with the regulation of the City of Fort Collins.
I/we understand that failure to comply withany of the above conditions may. result in revocation of
any permits associated with the above Permit Application number, forfeiture of any fees that have been
collected, a Stop Work Order and a court summons.
Sign in the presence of a Nota Public
W
wrier
,Owner
The yiing Affidavit was acknowledged before me this d y of
(month, year)by : —A p
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Witness my halc$ and cL* l sea :, o
My commissioff'e� �''-es: o=
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Notary Public
281 North College Avenue'° P.O. Box 580'• Fort Collins, CO 80522-0580 • 970 221-6760 • FAX 970 22• -
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