HomeMy WebLinkAbout152 W Mountain Ave - Affidavits/Owner Authorization - 04/20/2012Fort 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) %»-r e-' -e- 4A4,.,, as owner of record (property
address) IS;- known as (name of
business) .51�rna k - 0,,4 Se;,I~.7 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: Como., s GPesf Rven..v �x�-r,-�s. �-.-� to •�.�
/ems / ie��� �.•,. s� � �a.i/�..� �,
0 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
�f
(Property owner signature)
�' fm GfG..66\Y
(Property owner name; please print)
The foregoing affidavit was acknowledged before me on the X th day of
Alpwi s i o u (month, year) by T.,, (G Ya bhcarri
for the purpose therein set forth.
Witness my hand and official
My Commission expires
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