HomeMy WebLinkAbout525 Dennison Ave - Affidavits/Homeowner - 12/27/2010City'Of Planning, Deve'lopment.and Transportation
0 PC' Box 58G,
2-84 N College, Ave
Ft Cnllins;'CO 80524
970-Z21-6760'phorte 970--24-6134 fax
y`Ne, �'� Cjlr� t,,�. I� , as cwr,er(s) of record'cf the prcperf located
A:S� 1,jr.,v..�Z0 IlhJ� Fort Cailins,_Ccicrapo;.hereby dec.are and attest.,
to- the yellowing: (please check orjy the cre ;`ha^i acpffEs)
Q i arri/ we are acting on my/ our rehalf for the purpose of ottaining a builcing,:�permit and rerscnally
ccr+struc:ing my/corer home. The- home to be constructed is cn* ttte above prcpert? and will be riy/cur
primary residence. Vivo have act personally constructed nay other new homes in the Fort Ccilins
cite Ilrvis IN(thiri `she past 24-mcrrth,pericc►:
P' t arrJwe are acting on my/cur behalf for the perpcse' of abtairing a b6llding=permit and cerscnaily
constructing an alteration or addition tc my/cur house. Tne house to he altered is on the above
property and, is my/our personal residence.
Q 'l am%Ne are actirg. on my,/cut behalf far e.pyrppsa cf.obtaining- a"building, p � ,, `t and perscrai!`y
can�,.,,ctng a ncn-structural alteration to my/cur aftached singfe_famity..tiwelling, unit: The house
to be:altered is my/cur personal residence.. 1. art..awai a.�at !/�Ne cariret do airy sirup tril, _
electrical, plumbing ore me&ianicaf wcr`,c and racist hire c ntrac'.oreJsubccntractcr who are
currently licensed and insures with the City cf Fort Ccllins.
fan -,Me are personally performing all cf the work, or will be corntinueusly.superrising unpaid.vclunteers.
Tiie ,vcr,< is dir2ctfy related tc the construction or fl a hove referenced home, wl,,ich is described more fully
on Permit Appfcatie ( A 0 1 obtained from a '� w . � �. a ( r Building and Zoning arie�}. fhNe
understand ihat any erser�(s o ent(s�} ccntra�-r ed�to perfern structural wcce- frarr,ing, plumbing, HVAC,
electrical �+icr'i =rocfirg ci cast-in-place.structural ccrcrete were, IMUST•Ec licensed contractors it
accordance with the regirfaticn cf the City of Fort Collins.
VNe understand that failure to ccmply with any of the above corditicns may result in revocation cf any
permits associated with the above Permit Appiic<cn numcer, fcr`eiture c€ any fees that ha�re been
collected, a Stop Work Order and a court summons:
Sign zh tte preserca cf Notary Fu&tc
Gwrer
Cc -.wirer.
The foregoing Aridavit w?s acknowledged before me cn this xl�day cf
(-ncr;th, year) by
Vi ll-la-SS my hand and cfyicial s.=al
,4hj commission expires:
(`rotary Public