HomeMy WebLinkAbout1825 Terrace Ct - Affidavits/Homeowner - 03/09/2011Ptanrting, Deve{oprnent and'Transdortatibn
Box 5807
8,1 N CnEege AveCo[lin5
- Ft .s, CO 80524
970-2�1 6760 phone 970=%274-5134-f
Uwe, as owner of recur ' or t e proper / [cooled'
fy` ar �a{lins,_Ccicradq
A� t' hereey. d ,. _ ec'are and attest .
tc- the following: (ple2se c:tecc -riy the cre `hat acp/ies)
G l arm/ we arE,acl+ng on my/our hehalf for th6 puresa cf o*btahng a building; permit and :ors. hall
ccnstructing my/cur home. The hcrre to be canstn:cted is cri' the arcve procerty land wilt 6'e rriy/city
pnrn4iy residerice. irNe have nct personally ccnstn clad nay other new hcrnes in the Fart Cctiins
_.
city Ilkfs 1Nfthrn the�past-24-mdrtfl ,pertcd: -
i arrJ�r`ie are acting on riyleur behl.
dff for the parpcsa cr etalnrng a building pe �, it artd cerserially ,
ccnstrij&jng an aJteraticn Or additcn tc my/cur. house. l ne hcusc i0 be a1tEr2d iS OR tl}e riche
pro erg and, is .my/c+ r persona residence.
G 1 a-rrJAfe are gain en my/cur bhalf far lRe ur;,ose cF crrt2ining a building p6hma ar:� perscr lly
c6 r,i n:, Ong a ncn-st,-uc Ural alteraticn- tc my/cur attached single_pamiiy. `dwell�rtg urttt: Tree f dose
to be altered is my/cur peraCrial residence.. I. am.aware .that VNe can c'e any st,, rc;ur21,
electrfcaJ, plc.7r Bing era me aricwt wcr` and r;tcist Kira cL-.ntr_cter.:,'sut'ccrtracter Whit are
currengy licensed and irsures with the City cf Fort Cciiirs.
f aMONe are pe,5craily performing all of the wcrK, er will be ccntlrucusly'sucerrising unpaid vo(unteer.
Trte wort is drrzctfy relate etc tie c rsfr�cjicn cr iherarcv refernced home, which is described more fully
cn Parrot ApF{icaucn T IL�) �) �� �� �;� 1) 2 �� (0) fottained from Burldin e
g -and Zoning ef�ie�). (hvq
understan d 'any percn(s) or agents) contracted to perform structural wec� framing, pier ��ing, H�I.fiC,
------_-ele .real wcr`c, rdcfrrg Gts2st-ir-plecs:.stn:ctural-.ccrcratevcr4 LELtST Ec �csrsed--
ccc�r-'area wrth 3tfZe ra* g faucn cf the City of Fort Collins.
Uwe understard hat failure to ccmpiy with any cf the above ccrditicns may r esu{t in ravccaticr, cf any
permits asscc led with ire a_tove Permit Applicator. numcer, forfeiture cf. ary fees that rave been
cclleeted, a StooMork Order and a court sur rimcns:
Sign �7 J,,s;rosepcf Notary Futric
Air
er Cc-c wrer.
7
The fOC; GG11ng ARldc�lli 'Alas aC CriE4V{EC`gEd LflfvC r E cn this day C.r"
4 rG�1Li1 d��( (r: er:th, year) by
.Yt! IL hiss r� y . Ia d and C'f i ciz, Sce Do
e
(�Ity CGmtrnissicn
'urn'
�/%S "�ulrelneuu�t ��j Notan/ Public
soon Ex litres
' tiCommunity Planning and Environmental' Services
Building and Zoning Department
PERMIT AND INSPECTION REQUEST FOR
"= a EXISTING NON—STRUCTURAL CONSTRUCTION
Please print or type
Address:
Date:
I/W E / ' as owner(s) of
record of the above property, hereby request a permit for and final inspection of the
installation or construction work described in the following building permit
application, which work was completed or covered without obtaining a permit and
without required inspections during construction. I/we understand and agree that
the City of Fort Collins Building & Zoning Department will perform. a final inspection to
assess compliance of such work, some or all of which may be concealed by
permanent construction and finish materials, based on observable conditions and
nondestructive methods: and, that it may not be practical or possible for the City of
Fort Collins to verify full compliance with City building codes without removal of such
permanent construction and finish materials. I/we further understand that any
violations of City Codes related to health and safety associated with the above work
or installation may require correction.
Work performed by: UdI 66M-, `' VIWIDIAS Vw/0
N e Address
01
Date work perf rmed: �'
(Signature) Date
(Signature)
Date
3..0j'.-:7,0)1
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G 's
For office use only ................ � � ....® O. .� '0 ....................
l/ u
Permit/Appli.cation Number
Date applied:
281 North College Avenue • P.O. Box 580 o Fort Collins, CO 80522-0580 • (970) 221-6760 o FAX (970) 224-6134
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