HomeMy WebLinkAbout4820 S College Ave - Affidavits/Owner Authorization - 04/29/2010City Of Planning, Development & Transportation
F(' rt Collins 281 N College Ave P O Box 580
�_ Fort Collins CO 80524
Phone 970 416 2740 Fax 224 613
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
I, (Print)
BUILDING PERMIT
owner of record (property
1`_ known as (name of
business) /o- 1- /�j�� c .h� ,�7-) hereby authorize the
work listed below to be done on said property I understand that such work will only be
performed contractors licensed by the City of Fort Collins
am giving permission for interior work only The scope of the work shall be
limited to _ r r' e= :222 o ia-2:Z
❑ I am giving permission for extenor 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
limited to
4vor
(Property owner signature) (Property owner name please pent)
The ore
�,� gomg,affidavit was acknowledged before me on the oC 1 day of
```�� (month, year) by (��1 T rlM
3�,,�Vjpgey reirr set forth
mthessiny.hand and official seal
�1
mmi�oit~ex¢�'
%OP CON-"`-°
�rnn1nill"% O Notary Public
Permit #
OA9ce use only