HomeMy WebLinkAbout1025 Garfield St - Affidavits/Owner Authorization - 03/24/2015City of Planning, Development & Transportation
Fort Col -inins
s Er� 4281 N. College Ave
�i Phone 9Forlt Co170-416-274000 4 Fax 224-6134
411 9
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print)::,Mjcu 61ceea�as owner of record (property
known as (name of
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.
Er I am giving permission for interior work only. 11The scope of the work shall be
limited to: =Ng6� y-L A_ode l
❑ 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 :
�I �MIIEtJ I�.I • I�K.I��iZ
(Property owner name, please print)
The foregoing affidavit was acknowledged before me on the (�/ I I Z° C/ day of
W
( � hC 1 . �t
JD D (month, year) by Ic1((�
for the purp se therein set forth.
Witness my hand and official seal.
My Commission expires: "( ( — "a- d 1(0
Permit #
Nota Public
Office use only Ave M. Arnold
Notary Public
State of Colorado
Notary ID: 20084040738
My Commission Expires November 25,2076