HomeMy WebLinkAbout2133 S Timberline Rd - Affidavits/Owner Authorization - 04/21/2016Fort Colilns
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) e as owner of record (property
address) �`ti ��MbtX�W�G known as (name of
business) 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:
O 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
limited to:
(Property owner
( Property owner name; P/ease prInt)
The foregoing affidavit was acknowledged before me on the
ww 21 day of
DC'1i 1L0 (month, year) by &VV,)
for the p rpose therein set forth.
Witness my hand and official seal.
My Commission expires: M— to
Permit #
office use only
YiA,41", I J.--, CAL
Notary Public
LINDSAY REICHEL
Notary Public
State of Colorado