HomeMy WebLinkAbout2540 E Drake Rd - Affidavits/Owner Authorization - 11/15/2011City Of Planning, Development & Transportation
Drt Collins 281 N. College Ave
�FV Collins, CO 80524
e 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
� ^� I
I, (Print) J �cve ,S fa�e l n't c,�r as -ewner:-of record (property
address) ZS `10 6-,s4 0 J known as (name of
business) C 0r9 i ( -Eh C— 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:
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.
limited to :
X�v 44dKw
(Property owner signature)
The scope of the work shall
s{ e rc S+1;'d C (,*I Ir' C. /" +i /M,.- ,, ,-
(Property owner name; please print)
The foregoing affidavit was acknowledged before me on the day of
c/d�y�Yi� (month, year by
for the purpose therein set forth. �,`A1 111 7/
Witness my hand and official seal. o�Q OTA'p� to
My Commission expires: /a11101-2 Z (P C)
Or C'0¢�~\
i Notary Public
Permit #
Office use only