HomeMy WebLinkAbout1224 E Elizabeth St - Affidavits/Owner Authorization - 12/10/2015Fort
of Planning, Development & Transportation
F _ort Collins 281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
PERMIT
I, (Print)
owner of record (property
known as (name of
business) A:2- .A-:2}Q 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: k-sp• ;r�vc.t 6. i�JUV� b;� � �`jy"J :, 014G'
❑ 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 :
The foregoing affidavit was acknowledged before me on the _ /�/ day of
/�,('0_ .6W . ' (month, year) by S el(04
for the purpose the bin set forth. I n L of in-�_.Lr (�DL�_y\k-uj I COVO lea•
Witness my hand and official seal.
My Commission expires: J � -,-2D 00�9
Permit #
7� ol ��
Notary Public
Office use only TARA M. PEARL
(VOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20154045348
MY CON ISSIOIV EXPIRES 11/20/2019