HomeMy WebLinkAbout854 E Stuart St - Affidavits/Other - 08/30/2017Fort Colhns
1, Andrew Rauch
CERTIFICATE OF COMPLETION
OF SOIL AMENDMENT REQUIREMENTS
Pursuant to City Code § 12-132(b)
B1602672
Date: ap .2017
being the representative of (Company) FR Development and
recipient of Building Permit No. B 1 k0;NJr TZ for the property located at
(Address) SS4 STLtA l t 941ZOr T-
(Subdivision) River Modern (Filing) (Lot)
(Block) , in the City of Fort Collins, Colorado, hereby
acknowledge as a condition of issuance of the associated Certificate of Occupancy, and do hereby certify, that
have caused soil in the areas expected or intended to be planted on the subject property to be loosened and
amended in accoce��4ith Section 12-132 of the City Code of the City of Fort Collins.
By:
(Signature
(970 )284 -3200
(Phone number of signing party)
125 S Howes St 2nd R.
(Address of signing party)
NOTARY PUBLIC
NnTARV 10 OF 201744007617
Notary Public Seal
(970 ) 284 - 3200
(Company number)
Fort Collins, CO 80521
(Company address)
STATE OF COLORADO )
) ss.
COUNTY OF LARIMER )
Ap(it- et,A.) rAf hacknowledged the foregoing
instrument before me this �' day of �6LS�
20� . Witness my hand and official seal.
by F)y D VnIrl- gi ( LZ4 `,
(Notary's official signature)
My Commission Expires: 2 17 1 120.2
City of Fort Collins Staff Use Only
Date Received: By,
Landscape receipt or other proof submitted as proof of soil amending was found acceptable
Date Accepted: By,
Field Inspection (If needed) was inspected and found acceptable
Date Accepted: By,
Full Sign Off
Date Accepted: By,
Please Return Completed Certifications for Fort Collins Utilities
700 Wood Street - Fort Collins, CO 80521 - (970) 221-6700
Fm
Sales Roc erp( 46,,,4,�
Sloe I
v
HAGEMAU EARTH CYCLE
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co6,z CO W1�5
9,10 2i 1 71
StIl RalA L
P a :11 L Fl I tS
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ilellql,
0 Pi fE-
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RECEIPT TOTAL .
g94 STwic, awt-
1 % 6a () -1