HomeMy WebLinkAbout1801 S College Ave - Affidavits/Owner Authorization - 12/22/2011 (2)F®r'�t of
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)
xf�r
,owner of record (property
known as (name of
business) e j 7L 6 ZI�h �r/ (�� by 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.
Ef I am giving permission for interior work only. The scope of the work shall be
limited to:
Z I am giving permission for exterior work only. The scope of the work shall be
limited to: Sic Q zo✓c,
Zl' I am giving permission for interior and exterior work. The scope of the work shall
limited to :
Cz 67 0C GZ\ICJ d c t / ! o h .r 7eieCe G 71Y 1;:r
/lgerlav�
(Prope owners/gnaw) (Property owner name; p/ease int)
The foregoing affidavit was acknowledged before me on the a oZ. day of
QL0-C-P-^'t6-aA- 02'01 (month, year) by Les few- M
for the purpose therein set forth. KAI A LS
Witness my hand and official seal. N07TASIC
LT-
MyATE 0�ADO
Commission expires: a' a 3 % 1 My Commission Expires Feb. 23, 2013
55Notary Public
Permit
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