HomeMy WebLinkAbout619 S College Ave - Affidavits/Owner Authorization - 08/11/2015City of
F6rt 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
BUILDING PERMIT
I, (Print) CON �l e4g. (a f !, L C as owner of record (property
address) 612 Sett/L ev &t(, 41,1enk2 known as (name of
business) SOrcd, Go I(/GU C2/?
, CLC hereby authorize the
61
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 am giving permission for interior and exterior work. The scope of the work shall
limited to: buy AV%4, 4wcA,-a-,? a,. cl GBr.�•SG�$✓b�,l l r
&Val k Ca I I tp L 6j LLC.
lamer bq c -1-& z l
(Property owlidr name; please print)
The foregoing affidavit was acknowledged before me on the t' day of
%�✓ (month, year) by b
for the urpose t erein set forth.
JANELLE STULTS
Witness my hand and official seal. NOTARY PUBLIC
vl STATE OF COLORADO
My Commission expires: ✓ r �� / My COMM SSION EXPIRES APRL 21.2017
Permit #
Office use only
Public