HomeMy WebLinkAbout4609 S Timberline Rd - Affidavits/Owner Authorization - 02/09/2010City of O � a
Planning, Development & Transportation
F6rt C(4uW 0 4� 281 N. College Ave
Fart Collins, CO 80524
Phone 970-416-2710 Fax 224-6131
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
1, (Print) _.%_ r; v.��1ldY�i.C1�"-'"_1�� as owner of record (property
address)__. S . J�at! «'t- RoAc _ known as (name of
business) —Vff . L L L
_ hereby authorize the
work listed below to be done on said property. l understand that such work will only be
performed contractors licensed by the City of Fort Collins.
0 I 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:
C� I am giving permission for interior and exterior work. The scope of the work shall
limited to : 1-1 c, a. 1 vL, l L r " I C _J k - _
J �AA 1 h6td��c3��
(Propert), rxW signature) (Piopr,-), of mt�rn3na j fp:ttasr print)
The foregoing affidavit was acknowledged before me on the _ V� � day of
(month, year) by � �� � � �l 1 j'C CDC �
for the purpose ther in set forth.
6`'A HARTF
witness my hand and official seal. OQ�.,•'''••,0,9
�; ZyOTAR i .*.
My Commission expires: RM C� t'l�iL� n 0®
nary, Ar��t�
Permit
0f"re Ilse only
1 ,15-o S-RS'
ent Transportation
Clty}of Planning, Developm & p
Fort �®t�� n5 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) j t J LL�as owner of record (property
address)__.I _ S' , T��t! ? _-'_ __ —known as (name of
business) .. L L . __ .,_�.__ _— 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
limited to:
1
❑ 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 : _ e vi o
i
I' V ` `. Li 1 V°' y
signature)
(Property owner nam please: print)
The foregoing affidavit was acknowledged before me on the day of
�0.Y 00\ Q (month, year) by _V f OCD
for the purpose ther in set forth.
HARTFO
Witness my hand and official seal. • • ,9
OTAR
My Commission expires:
o�Y C�) al a pl t-)
. "OF COV
Permit tf
Offrce use only