HomeMy WebLinkAbout1640 Riverside Ave - Affidavits/Owner Authorization - 10/16/2015 (5)Fort 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) Matthew Corey Seitz
owner of record (property
address)1640 Riverside Avenue, Fort Collins, CO 80524 known as (name of
business) Riverside Storage 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:
[A I am giving permission for exterior work only. The scope of the work shall be
limited to: Footings & Foundations
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to :
(Property owner signature)
(Properly owner name; please print)
The foregoing affidavit was acknowledged before me on the /h Y' day of 1
G1 ��L cl �%5� (month, year) by �f�Yfitn u> &-W
for the purpose therein set forth. J
Witness my hand and official seal. AM83ER RATHERT
NOTARY PUBLIC
My Commission expires: o i l I Z/Zc i y STATE E OF Ryil CO4pRgsC
MY COMMISSION f1IR S J USF
! r;' t. T' ! i () Not, " Public
t� 1. rv� lJ
Permit
Office use only