HomeMy WebLinkAbout430 N College Ave - Affidavits/Owner Authorization - 05/14/2015CityOf Planning, Development & Transportation
�on Collins 281 N. College Ave
Fort Collins, CO 80524
r hone 970-416-2740 Fax 224-6134
3 7
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
owner of record (property .
nown as (name of
business) IF'Nco ► ii > L� A i6 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:
I am giving permission for exterior work only. The scope of the work shall be
limited to: I g TAI.LA-Tc OAS of:: H0?P6K
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to :
'4" zgo��
lM�ro�
(Pr eny owner slgnature) (Property owner name; please print)
The foregoing affidavit was acknowledged before me on the �(— day of
�`a ,aolS (month, year) by-ctU\- -Max-f10(L
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: t I 19 1 I y
Permit #
Office use only
Notary Publlc
HELEN E. MATSON
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20104001203
MY COMMISSION EXPIRES JANUARY 19, 2018