HomeMy WebLinkAbout3500 S College Ave - Affidavits/Owner Authorization - 04/27/2016F®rt of
/11' .
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) _baV'r0.' l L- 9 n udson as owner of record (property
address) 3 580 S. CblleaP_ 70"t . known as (name of
�hS business) e 4 , _*Are. S1'Z jpp + nn na l�er,IV" 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:
❑ I am giving permission for exterior work only. The scope of the work shall be
limited to:
VI am giving permission for interior and exterior work. The scope of the work shall
limited to :
(Property owner signat re (Property owner name; please print)
The foregoing affidavit was acknowledged before me on theh day of \\—
Bpi:1� (month, year) by .Y-re.�� L_
for the purpose therein set forth.
TAMMARA L HANAWAL
Witness my hand and official seal. NOTARYPUBUC
VATS N CRORADO
WTARYI0 20064016351
My Commission expires: WCOMMMONE(PIRESOCIOBER ?Ct�'
Notary Public
Permit # o aa5 a
OfAce use only
NU09a53