HomeMy WebLinkAbout2950 Neil Dr - Miscellaneous - 04/11/2001JUL-11-2001 WED 09:46 AM FC BUILDING AND ZONING FAX NO, 9102246134
P. 03
Building & Zoning Dept.281 N. Fort Collns,Colloollege raaddoo80822-068080
Community Planning and Environmental Services Phone; 070 2218760 FAX; 970 224 6134
HOME OWNER -BUILDER AFFIDAVIT
UWe,
located at:
TUFASE PRINT]
, as owner(s) of record of the property
Fort Collins, Colorado, hereby declare and attest
to the following: ; CJft
1. I am/we are acting on my/our behalf for the purpose of obtaining a building permit for the construction
or alteraltion of mylour home. The home to be constructed or altered is on the above property and
is mylour personal residence.
2. 1 amlwe are personally performing all of the work, or supervising unpaid volunteers or'employees- (see
PPM 58 attached) who might be assisting with any of the work related to the construction of the above -
referenced home, which is described more fully or. Permit Application No. (obtain from
Building &Zoning Office). �� � � ��
3, Itwe have not personally constructed any other new home h a o
4. I/we understand that any persons or agents contracted to perform structural framing, plumbing, HVAC,
electrical work, or roofing, MUST BE licensed contractors in accordance with the regulations of Fort
Collins.
5. 11we understand that failure to comply with any of the above conditions may result in revocation of any
permits associated with the above Application Number, and forfeiture of any fees that have been
ST
)ss.
COUNTY OF LARIMER )
DENISE ULRICH
Notary Public, Allegan County, MI
My Commission Expires Jul 5, 2005
(yThe foregoing Affidavit was acknowledged before me this day of �L
'
�u�' , by Za' f/7cL 4 T 0' eVj
Witness my hand and official seal.
My Commission expires:
Notary Public