HomeMy WebLinkAbout1939 Jessup Dr - Affidavits/Owner Authorization - 05/28/2014City Of p Planning, Development & Transportation
0 t For N. College Ave
E(�1J1 Fort Collins, CO 80524
17 Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) �)-e,ssup farm L— -C as owner of record (property
address) q 301 known as (name of
business)( Loocf-1 x S'r* 1COSNnP am 1VV%1an --V �lhefeby 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: CoYe `� S��` '� cv)d T-tno'n- - Rwz5 n
(Property owner signatu
jcs:�uP arm I \..-Lz
L-A►ro C0.mi?Lvati My)
( periy owner name; please print)
The foregoing affidavit was acknowledged before me on the 2s' " day of
(month, year) by C01-00 a m
for the purpose therein set forth. JENNIFER FELLINGER
NOTARY PUBLIC
Witness my hand and official seal. STATE OF COLORADO
NOTARY ID 20044044223
MY COMMISSION EXPIRES 07111
My Commission expires: to I (% -zoo �\
Permit #
Oft a use only