HomeMy WebLinkAbout213 S Sherwood St - Affidavits/Homeowner - 02/19/2014 (3)p _ COX y y RECEPTION#: 20140010973, 03/05/2014 at
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f Angela Myers, Clerk & Recorder, Larimer
County, CO
AFFIDAVIT
(as required by Section 4.7(D)(3), Section 4.8(D)(3)
or Section 4.9(D)(3) of the Fort Collins Land Use Code)
I/we, -3PA H o P S Koji LF (L ; as owner(s)-of record of the property located __-
at: Z ! � S ; S%yFu qi� o k S 4 . , Fort Collins; Colorado, hereby declare and attest
to the following: (please check only the one that applies)
I am/ we are acting on my/ our behalf for the purpose of obtaining a building permit for a new,
detached accessory building to be constructed at the above -listed property. The building will be
constructed with water and/or sewer service. By signing this affidavit, I/we declare that the building
will not be used as a dwelling unit.
❑ 1 am/ we are acting on my/ our behalf for the purpose of obtaining a building permit for an alteration
to an existing, detached accessory building located at the above -listed property. The alteration
includes adding water and/or sewer service to the existing building. By signing this affidavit, I/we
declare that the building will not be used as a dwelling unit.
I/we understand that using the building as a dwelling unit without approval from the City of Fort Collins will
be a violation of the Fort Collins Land Use Code and could result in a court summons.
Sign in the presence of Notary Public, record the document with the Latimer County Clerk and Recorder, and submit a copy of the
recorded document with the building permit for the work checked above.
Owner Co-owner
The foregoing Affidavit was acknowledged before me on this i Vh
day of
�c4orut;r�� - 2v iLl (month, year) by krI'br) mc..1, ie Sknl,e�� C
J
Witness my hand and official seal
My commission expires: 1 z / 19 JiZ b I t;
KRISTIN MARIE STFF'H
NOTARYPUBLi? i
STATE OF COLOR. ,10
NOTARY ID 20124031120
COMMISSION EXPIRES DEC.19, 2016
Notary Public