HomeMy WebLinkAbout1600 Specht Point Rd - Affidavits/Owner Authorization - 02/10/2010 (2)Community Planning and ]Environmental Services
Building and Zoning Department
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OWNER AUT6= ORIZAg�'B®g0� TO OBTAIN A (�®o�00�ul�Rtf XAL
NG PERMIT
I, (Print) -��� �-�f) as owner of record (property
v--
Address) `fQi*�/R r DZ known as (name of
business) as or,'I'ms u-P 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.
0/ I 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
(Property owner signature)
The fo egoing affidavit was nowledged before me on the i —day, of
r (month,year) by D7540�c ll-
for the purpose eedn set forth.
Witness my hand and official seal. �'' �t{Y Wi
�P•..........•,Np
'tZj0 Tq,9 �9
My commission expires:
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N tary Public ��'• ejSL`G:'PO
pF C pP
Permit #
(office use only)
281 North College Avenue ^ P.O. Box 580 ^ Fort Collins, CO 80522-0580 - (970) 221-6760 - FAX (970) 224-6134