HomeMy WebLinkAbout2727 Canby Way - Affidavits/Homeowner - 08/10/2011�... ... Plannin , p sP
t` � bevel m c - g� o ent:and Trap ortafion
Collins 8 Bpx chle
281 N College Ave
Ft t6lfirfe, 0`90524
9.70-221.76760 phone 970-224'6134fax
i/we, / , as owner(s) of recard'of the property located
`17 At: A. �i , Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies)
l 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'thd above property and will be my/our
primary residence. Vwe have not personally constructed nay other new homes in the Fort Collins
city limits within -the past '24-month-period.
i
1 am/we are acting on my/our behalffor-the'purpose, t.abtaining a:,;bu.7ding permit and personally
constructing an alteration or addition to my/our house. The house to be altered is on the above
property and is my/our personal residence.
I am/we"Are acting on my/our behalf for the purpose of`obtaining a building 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 d'o' any structural;
electrical, plumbing, ore mechanical work'and must`hire'contractors/su6contractors 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 supennsing. unpaid volunteers.
The work is directly rel thcq t / ia� qhe above referenced home, which is described more fully
on Permit Application # (obtained from Building and Zoning office). i/we
understand that any pe n_( or�ag t(s cot cte,o perform. structural wood -framing, plumbing, HVAC,
electrical work, roofing. or cast -in -place structural concrete:work, MUST BE licensed contractors in
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, a Stop Word Order and a court summons. -
Sign in
Co-owner
Ale foregoing Affidavit was acknowledged before me on this _ / day of
Ott <. Al%(month, year) by Q
Witness my hand and official seal
N4My commission expires: H0SLII
rpA�,:
y' A
121
C&L k
KN�J�P*.i,
Notary Public