HomeMy WebLinkAbout2913 Skimmerhorn St - Affidavits/Homeowner - 02/25/2010BI000999
NCothns
Planning Development and Transportation
Po Box 580
281 N College Ave
Ft Collins, CO 80524
970 221 6760 phone 970 224 6134 fax
Uwe, 772�/ZY ) 676M as owner(s) of record of the property located
At 29 i3 616 moo &z UUYU� b/h . 7- Fort Collins, Colorado hereby declare and attest
to the following (please check only the one that applies)
❑ 1 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 nay other new homes in the Fort Collins
city limits within the past 24-month period
X1 am/we are acting on my/our behalf for the purpose of obtaining a budding permit and personally
constructing an alteration or addition to my/our house The house to be altered is on the above
properly and is my/our personal residence
1 am/we are acting on my/our behalf for if a purpose of obtaining a budding permit and personally
constructing a non-structural alteration to my/our attached single family dwelling unit The house
to be altered is my/our personal residence I am aware that Uwe cannot do any structural,
electrical, plumbing ore mechanical work and must hire contractors/subcontractors who are
currently licensed and insures 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) Uwe
understand that any person(s) or agent(s) contracted to perform structural wood -framing, plumbing HVAC
electncal work, toofing or cast -in -place structural concrete work MUST BE licensed contractors in
accordance with the regulation of the City of Fort Collins
Uwe understand that failure to comply with any 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, aStop Work Order and a court summons
Sign In the presence of Notary Pubrrc
owner
Co-owner
The foregoing Affidavrt was acknowledged before me on this 5:;� S day of
s��d (month year) by
Witness my hand and official, seal
,O%ADELL
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Notary Pubhic