HomeMy WebLinkAbout2700 S Lemay Ave - Affidavits/Owner Authorization - 03/31/2014Clt)/ Of Na ing, Development & Transportation
F„�rt Collin' ollege Ave
III M ,� ;.100710-416-2740
ns, CO 80524
14 °� Fax 224-6134
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BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) K1T #40KIN5 FflR C'ff.e157- as owner of record (property
address) Z70V S 14EmAy Avg known as (name of
business) C49(fr LE,jTEK Com0v-J Ty C9wrrcH 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: tAtJW,�APr tyYp eaft-pl,(el
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to
owner signature)
The foregoing affidavit was acknowledged before me on the 3/ day of
„f y • t, r d eial y (month, year) by �if il.s
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: IAIIXIa lfi DNA SC�y
Notary Public NOTARY
Permit # PUBLIC
r Ofte use only O
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