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HomeMy WebLinkAbout406 W Laurel St - Affidavits/Owner Authorization - 10/06/2011'�I,1b�4�S �3►loq�ls Oct 4 Cj� JO " 4- Planning, Development & Transportation Fort Collins 281 N. College Ave Fort Collins, CO 80524 -' Phone 970-416-2740 Fax 224-6134 BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL BUILDING PERMIT trvTv I, (Print) f 4YA" t j 61-kK� n E� G (% � a owner of record (property 41-/- Fa KT (OGLf N5, �/e> qP C> k� address)4D3- � ea!� (036 M Rv yr known as (name of business) E%C I�ST 7(ow TR9TA- (01M:b lLvg)a 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. XI am giving permission for interior work only. The scope of the work shall be limited to: 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 limited to : F UL-4- /) CzjiL j7-toN !± KE m& U,+L 'o F AGL SifRyC-TL'2E'5 bo.C'*Tef) aN Tfte 140b LessG® �' G-1 STE© fj ec> Ve, Q514p.N TlteTA t/&R ..' I?.��� 13tZtrr•�f�N &% Vt'Ei3e_ 4� PR.6sr()eN*T (Property o ner signature) ( Property owner name; please print) E TG . PR6to>:�• ��r` The foregoing affidavit was acknowledged before me on the day of (month, year) by for the purpose therein set forth. Witness my hand and official seal. My Commission expires: Notary Public Permit # Office use only V/T lob 0 bn r60, 000-55U-kiII1