HomeMy WebLinkAbout3500 John F Kennedy Pkwy - Affidavits/Owner Authorization - 02/17/2011City of
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Planning, Development & Transportation
81 ollege Ave
C011ins,
`Fort C CO 80524
Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) Nv ��. U o as owner of record (property
address) 35W i'E,K &r�wn k,,/ known as (name of
business) W s an L r.f '� r� 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.
I am giving permission for interior work only. The scope of the work shall be
1 I — - I
limited to:
❑ I am giving permission for exterior work only. The scope of the work shall be
limited
❑ I am giving permission for interior and exterior work. The scope of the work shall
imited to :
L —'—��k-=---'�- S'Y�il� iJ5' • �Jii`alHali: l�Grir,�O� Y+�a(icf� /'(aWar/pr"w`!�'_''" ` �
(Property owner slynature (Property owner name; please pant)
a
The foregoing affidavit was acknowledged before me on the day of
ir�o.�ni�,tst ►-�4 . %-�1 (month, year) by Abo'c4/'� �-�ino� T z�i � R 01�-
for the purposrtherein set forth.,Ir,-6q,4d4Pe4 8V
C�e�e.+-c�Q I�G°�•'dY�a�• � /�/Or�2.�/��r��iea-�Dr LC.C./o
Witness my hand and official seal.
My Commission expires: (j0--? C2.ol SF
Permit #
Office use only
Notary Public
NOTga�.:2
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