HomeMy WebLinkAbout2215 Dolan St - Affidavits/Homeowner - 01/03/2010F City
Cott ins
Ptannmg, Developmeit.and TTansaortaticn
281.N Catiege�ave
Ft Caffinsp CO 90514
970--721-6750'phone 970='_4-6134ax
vwe, -IL-) a L c kDe yr t o i S as cwner(s) of record' cf the prop ' � y Iccated
A; �2.1 S J �� ��, S �r �e i Far, CcflinsCcicr3de;. hereby dec.are and attest
ic: the following: (F/e2se check only the one tf'ar acplies)
Q 1 aril/ we are acing on my/ our behalf for the purese .cf obtaining a building.�ermit and perscnaff
c6onstructting my/cur home. The home to be ctnstructed is on, the 46cve property and wilt be riy/cur
primary residence. V,,ve have rct,perscnaliy constructed nay other new homes in the Fort Collins
_.
cello (trots +,within- tfte past 24-martft pertcd:
Eel 1 am/�Ne are acting on my/cur behalf for the perpcsa, cf ci ttairing a b6ilding permit and erscnait�
p !
conStructlrg an alteration or addition iG my/cur hcuse. The house to be altered is on the above
property and,. is my/cur personal residence. -
1. a�. ace acting. cn my/cu,r �er�aif `or fi'�e.ryrpcse ct cbt2ining a building per�^it and personalty
cdnst , �ing a ncn-structural alteratfcn to my/cur armc`hed single.famiiy d�brel(ing; unit: `l`ize hcuse
to be altered is my/cur personal residence- I. arn..aware that Vva carir�at do arty strucii. .
electrical, plumbing era mecnanical wcek and must hire ccrtracters/sut contractors wl'o are
curTertty licensed and insures with the City of Fort Ccirrs.
f arr,Me are personally, �e�mrmicg all efte wcr�, Qr will be continuously, supervising unpaid yclunteers.
The wrcr'< is directly retaf d U tf e c%rts`a :e`.icrler�ff 9e cve referenced home, which is described mere fully
on Permit Appifcaticn U L .,ter (et:tained rem Building a^d Zoning office). ONE
understand that any peror(s) or agent(s) crntracted to perfortt structural wee�,ran jing, plumbing, HVAC,
electrcal won't; roofing Gr cast-in-piace.strJcturJ concrete work, IMUSTEE licarsed contractors it
acccrCanc3 with the re ,ufatfcn of the City of Fort Collins.
Uwe understand that failure to ccmpfy with any of the above conditions may result in revocation of any
permits asscc ated with the abcve Fermit Apafkaticn number, fcr`eiture of any ices that have been
c fleeted, a Stop Work Order and a cart Jia imena:
sgn rh t�.e przse „s f �Vctary
Cc-cavrer
The for going Ar1davit was ackncwlEdged before me en this
/ day of
JOVI t4AJ o U l I (-ncnth, year
VII!L Bess my hard and cfiiciai s.:al
Vi cc-mr::is:.icn expires
Notary Public