HomeMy WebLinkAbout1303 Frontage Rd - Affidavits/Owner Authorization - 10/22/2014.Itv 0i Planning, Development & Transportation
281 N. College Ave ins 'r Sort Collins, CO
'410 hone 470-416-27o404 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING .PERMIT
I, (Print) M IGlr� '� fF'rr5ras owner of record (property
address) 1-103 r'w tWti'AC,f 4.t) 'known as (name of
business) herebyauthorize the
work listed below to be done:on said property. I understand thatsuch 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:
0 I am giving permission for exterior work only. The scopezof the work shall be
limited to:
0 I am giving permission for interior and exterior work. The scope ofthe work -shall
(limited to :
(P y rrtersignatur (Pmperty,aivnername; please print)
i'
The foregoing affidavit was: acknowledged before me on the ��✓_j day o`
(month, year) by Ml(-hWj7 L 171 3fL�
for the purpose therein set forth.
BRAD HENDRY
Witness my hand and official seal.---�""�/ "' NOTARY PUBLIC
ATE OF COLORADO
My Commission expires: � % 1 ��1 � NOTARY ID 20114043721
MY OJli!SS! NEXPR`SJULY;5.2015
Permit m
office, use only
C,_1<6V1ew
Notary Public