HomeMy WebLinkAbout1801 S College Ave - Affidavits/Owner Authorization - 12/22/2011 (3)Fort Collins
11111
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)
owner of record (property
as (name of
authorize the
work listed below to be done on said property. 1 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:
7L-4 / ;1;!�,W
0 I am giving permission for exterior work only. The scope of the work shall be
limited to: SC -e ca Zo ve--
I$' I am giving permission for interior and exterior work. The scope of the work shall
limited to 7Lri4 e- 1u �� (-A= Rio o/i -"c /s 6 a"�
CHOP GZ\ICJdce //eh \F71✓'CeG�,r/R('c,/R/XJ
(�rFy ownersignat k �— (Property owner name, p/ease nnt)
The foregoing affidavit was acknowledged before me on the c? oZ day of
0-aC-.-"I6J?/`- 02-01 (month, year) by Les }ems— M _
for the purpose therein set forth. i�IjSTA NI. MANIbb
Witness my hand and official seal. NgrASY PUBLIC
STATE ()F COLORADO
My Commission expires: p� a 3 % d-o / Y res Feb. 23, 2013
My Commission Exp
NOtary Public
Permit 35.5
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