HomeMy WebLinkAbout3500 John F Kennedy Pkwy - Affidavits/Owner Authorization - 10/02/2014Fort 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
B ILDING PERMIT
-'T"NK'M
I, (Print) NS ( (.�-�.i� __ as owner of record (property
address) ZFK PO&AIao .Wo known as (name of
business)
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: +ennni wylc% 1VNdjes
c,goine�s 1 r�tav►'i�r.�,r�e.f
❑ 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 :
?W-
Dad
(P ope caner signs re (Property owner name; please print)
The foregoing affidavit was acknowledged before me on the day of
®C l ul/e/Y�", ez[��� (month, year) by /Da.d a �'l
for the purpose therein set forth. �7
to 0 F A)0rW-6)bV_ .1�c�ROFiv�nFd�
Witness my hand and official seal.
My Commission expires: L I ()_q
Permit #
Office use only
Notary Publl
KRISTINA IORSON
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID N 20104052434
MY COMMISSION EXPIRES NOVEMBER 29. 2018
�o,r