HomeMy WebLinkAbout1025 Garfield St - Affidavits/Owner Authorization - 03/24/2015 (2)Cityof
Planning, Development &Transportation
Fort Collins, 281 N. College Ave
V{�pq Fo 'Collins, CO 80524
I j �` � �h 0 970�16-2740 Fax 224-6134
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BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
�� BUILDING PERMIT
I, (Print) �VIf►•t�EL ��t;� as owner of record (property
business)
known as (name of
'A-u 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:
le
❑ 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
(Pio rty o er signal a (Property owner name; please print)
The foregoing affidavit was acknowledged before me on the day of
!� LEG ,10 � S (month, year) by
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: /I _ a S -a 0 � 6
Permit #
Office use only
/ Y ,/ i:Z4- &e:::i66�
Nota
Ava'M. AM61d
Notary Kubik
Stito Of Colorado
Notary Mi 2008404738
Y Commiseion Explies Novapnber 95,2016