HomeMy WebLinkAbout1612 Specht Point Rd - Affidavits/Owner Authorization - 11/20/2005Community Planning and Environmental Services
Building and Zoning Department
Citv of Fort Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print)`! sLAc! L ( A9rf %-) as owner of record (property
Address)
1 ,IZ
...S,06!/T` jj/, 2t /2,
known as (name of
business)
Cb
Vn")'t
) S LL p
hereby authorize the work
listed below to be done on said property. I understand that such work will be
performed only by 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
XI am giving permission for interior and exterior work. The scope of the work shall be
limited to /—I?,— z�-1-5AM.lf'&'
Property owner signature)
The foregoing affidavit was acknowledged before me own- t'h�e,
(month year) by�_G
for the purpose therin set forth.
Witness my hand and official seal.
My commission expires:
rT�6V- '?, D, 3-00L-C
Permit
(office use only)
v ate— RY'PU
DEBI L.
GOAD '
OF r�L
Notary Public
My Qxnmisslon Expires Nov 20, 2006
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134