HomeMy WebLinkAbout3500 John F Kennedy Pkwy - Affidavits/Owner Authorization - 06/25/2012City of
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
address
busines
owner of record (property
.nown as (name of
iereby 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.
l6 I am aivinq permission for interior work only. The scope of the work shall be
❑ 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 :
S° z
(Propeny owner sig to J (roperty owner name; please t)
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cewn , t) A 0.n mP.l- J
' J he foregoing affidavit was acknowledged before me on the
j_
�1 p lU—0`/1J (month, year) by /c
for the purpose therein set forth. SY
Witness my hand and official seal.
My Commission expires: l L [2-R
Permit #
Office use only
2 L) — day of
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