HomeMy WebLinkAbout216 N College Ave - Affidavits/Owner Authorization - 03/13/2017Fort 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) Kevin Brinkman, Manager of 200 N College, LLC as owner of record (property
address) 200 N College known as (name of
business) The Exchange Re -Development 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:
I am giving permission for interior and exterior work. The scope of the work shall
limited to :
(Property owner signature)
Kevin Brinkman, Manager of 200 N College, LLC
(Property owner name; please print)
The foregoing affidavit was acknowledged before me on the i3 day of
iM lJ-� C40 (1 (month, year) by KaVrn Bft44VWA, MAnaW e-e20o IJ. Coll Se ,Lt-C�
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires:149/"
B17�6
Permit #
Office use only
Nota blic
GAYLE E SCHMIDT
Notary Public
State of Colorado
Notary ID # 20164046536
My Commission Expires 12-08-2020