HomeMy WebLinkAbout215 E Foothills Pkwy - Affidavits/Owner Authorization - 05/08/2014'City. toQlns
PlannIM Devebpment rit Transportation
261 N. College Ave
Fort Collins, CO 80524
Phone 470-416-2740 Fox 224-GLM
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print)e.�s►✓ /�%P./'ia�-�� //w�aarl!//Slo► OYVillr�ofe0ord (ll�r1Y
address) .2 /5/ ,OF. A 0401f P� , � (7 known as (name of
business)' /%7 ��/�s /030/% hereby autlariae the
work listed below to be done on said property. I understand that such work will only be
performed oontramor�a Iloensad by the City of Fort CoRm
❑ I am giving permission for interior work only. The scope of the work shall be
limited to:
❑ I am giving permiwlon for aftrior 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
urnitedto
Q" I& F&04 nr,43
(foMarYMW AbUa: AtION F*t)
The foreWng affidavit was adawwkdged before me on the day of
(month, year) by B.a. U A4 pA g L A-*J n
for the purpo herein ad forth.
WMmos my hand and official seal. o0911
/-so—�D/7 ;•NOTARY
. pVE LIC
Permit 9•.••,
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