HomeMy WebLinkAbout3500 John F Kennedy Pkwy - Affidavits/Owner Authorization - 10/06/2011City of Planning, Development & Transportation
Fort Cot ,2 N. College Ave
�Fart Collins, CO 80524
8 4 9('Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print)44SL r Tr � 1 as owner of record (property
address) �� QFK &r'kI ••S&4 T� 32-S Cod Known as (name of
business)
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.
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:
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to :
�ano9cwV4Irre• .
(� Property owner sign u ) (Property owner name; please print)
State of Colorado )
County of Larimer )
SS.
The foregoing affidavit was acknowledged before me on the day of
roh, V u (month, year) by &,Vl 1 �, � f- 1 r e41"C1C1'4 O�
for the purpose herein set forth.`F�y a� /iiQ e�ef1-hi
Witness my hand and official seal.
My Commission expires: 1 C�zq./j 61 `f
Permit #
Office use only