HomeMy WebLinkAbout1544 Oakridge Dr - Affidavits/Owner Authorization - 11/24/2015City of Planning, Development & Transportation
Flirt CollS 281 N. College Ave
15083 Epa Collins, 80524
one 970-41616-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) 1ur-L- I- (')P.\IP,YN as owner of record (property
address) 1544 OQA V— iL 6 ct?, 1� C known as (name of
business) r-; It , P. PP2r1YP.r hereby authorize the
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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
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limited to: T %\ -,-c ,nr 1-'0.n?.n I Lnla� . %lp,i. � 111`F 3 l t lallS
❑ 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 :
owner signature)
(Property owner name; please print)
The foregoing affidavit was acknowledged before me on the a4 day of
t�bisom,bPI) c90 IS (month, year) by
for the p rue for therein set forth.
Witness my hand and official seal.
My Commission expires: :Gnuaryr
Permit #
OPfce use only
ROBIN K BUSTEED
NOTARY PUBLIC
STATE OF COLORADO
NOTARY iD 20054002578
IMY COMMISSION EXPIRES JANUARY 20, 2017
61luinl� �IIC�LoG�
Notary Pub/ic