HomeMy WebLinkAbout216 Linden St - Affidavits/Owner Authorization - 02/13/20123 /a06&Z/
Fort Collins
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) J (4 d ILC f C��cJ� as owner of record (property
address) ,D-1 � ki'rn jeo. known as (name of
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
'�<I am giving permission for interior and exterior work. The scope of the work shall
limited to : 77 A0"J i I—= /=c_. &z g: /,
owner
(Property owner name; please print)
Thee foregoing affidavit was acknowledged before me on theI �day of
�i�YU/t l�l�i .201 A (month, year) by Tu/ (4-h /
C �'V 1 �IetpwA
for the purpose t erein set forth.
Witness my hand and official seal.
My Commi ion xpires:
�N1 d—
Permit #
Office use only
SHEENA LEE
NOTARY PUBLIC
STATE OF COLORADO
Notary