HomeMy WebLinkAbout1213 W Elizabeth St - Miscellaneous/Owner Authorization - 07/28/2005Community Planning and Environmental Services
Building and Zoning Department
City of Fort Collins
00504016
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) l �,c y►�c_.Jl.t I [ .d � n s �. �. Y
as owndr of record (property
Address) lZ%3 ',/ higzl -
�'� known as (name of
business) 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.
XI am giving permission for interior work only. The scope of the work shall be limited
❑ 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
4�7owner signature)
The foregoing affidavit was acknowledged before 29�
day of
-IQ CC � (month,year) by
for the purpose therin set forth.
Witness my hand and official seal.
My commission expires: 5120109
Permit ,#
Notary Public
(office use only)
2,81 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134