HomeMy WebLinkAbout1129 W Elizabeth St - Affidavits/Owner Authorization - 05/03/2010Conununity Planning -aid Envuorunental Seivices
Building vtd Zoning Dcplrlmeni
Cil� of roi I. Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDINGPERMIT
I (Print) _ l (t C,0 _� �1t� [A,55 mil' L L? as owner of recoi d (property
Address) 11g% e ��/� �j[ +
known as (name of
business) /-OLQ 9* hereby authorize the work
listed below to be done on said property I understand that such work will be
pe
rformed only by contractors licensed by the City of Fort Collins
I^am giv�y,p��mon lr e��r on�y T scope�f t}ae work shall be limited
F/
o I am giving permission for exterior work only The scope of the work shall be limited
to
o I am giving permission for interior and exterior work The scope of the work shall be
limited to
The foregoing affidavit was acknowledged before me n the 3 � d of
% 0 (month year) by �L
ror the R rpose therm set forth
Witness my hand and official seal
My commission eypires -C/ /15
Notary Public S�� dd
P rmit
Wfice use only)
No th Colle,e PN enue PO Boa 580 Foi t Collins CO 80522 0580 (970) 221 6760 FAX (970) 22, 61 4