HomeMy WebLinkAbout2720 Council Tree Ave - Affidavits/Owner Authorization - 09/14/2011Flirt of
Planning, Development & Transportation
281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) Scott Bloomston as owner of record (property
address) 2720 Council'Cree Ave, suite 106, Fort Collins, Co 80525 known as (name of
business)
MKLaren
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.
X I am giving permission for interior worts only. The scope of the work shall be
limited to: Metal assemblies, Finishes, flooring, painting, drywall, HVAC, Plumbing & Ele
Install sign and Blade sign.
El 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
limited to
(Pr 4ownersignature) (Properlyownername;p/ease print)
The foregoing affidavit was acknowledged before me on the �day of
kP71FA02- gal ( (month, year) by G S(b7'T '310OtiIS7-OA/
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires:
1093
Permit A
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4 pp
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Office use only
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Nota b is