HomeMy WebLinkAbout1220 Oak Park Dr - Affidavits/Owner Authorization - 04/05/2014Fort Collins
Planning, Development & Transportation
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)
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V� rVV+a N11-i
as owner of record (property
address)
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Ir.
known as (name of
business) o ott-%-7 , N e. 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. The scope of the work shall
limited to: W-W eci-kc) was, k r, +o -t-tz S c,:-Xe
l
roperty owner signature)
(Property owner name, Please print)
The foregoing affidavit was acknowledged before me on the day of
f t I 4001e
__ (monjh,_vPar) b�v
TO
for he purpose therein set forth. a SHELLY RIMARU
Nobry PW*
Witness my hand and official seal. Soft of Colort0o
Ivry io 2008400661113
My Commission expires: M Conossim E Jul 302017
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U � � � Notary Public
Permit #
Ofice use only