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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 My commission Ypres z RY P c PV0 e; G0r0k"ci STA OF .�•',Q�Q �OMMISSO w1w®ro'non!'/ Notary Pubhic