HomeMy WebLinkAbout2720 Council Tree Ave - Affidavits/Owner Authorization - 05/21/2012B I 20,3111a9ingOevelopment & Trans ortation
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Forof ollins
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) ��� as owner of record (property
P K,,, I
address),2710 Cstmmc,il le Oil,-Su4t Z 90 known as (name of
business) M � r Y qt� !�; '0i4r- 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
L9 I am giving permission for interior and exterior work. The scope of the work shall
limited to : 2.e� �t\A C..!: J Y ci.a��l
(Property owner signature)
The forego affidavit was acknowledged before
(month, year) 1
for th a therein set forth.
Witness my hand and official seal.
My, Commission ,
K4THERYN S. DAVIS
Notary Public
State of Alabama
: ; i MISSION EXPIRES: MAR 25.2016
Permit #
Ofce use only
(Property owner name; please print)