HomeMy WebLinkAbout615 W Lake St - Affidavits/Owner Authorization - 08/22/2018City of
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) CSU Research Foundation
owner of record (property
address) 615 W Lake St. known as (name of
business) 615 W Lake St 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:
CK I am giving permission for interior and exterior work. The scope of the work shall
limited to : Complete Demolition of the residential building, driveway and
exterior concrete not in the city ROW.
- c�v
Michael 'Bo' Brown Sr. P.M.
(Property owner signature) (Property owner name; please print)
The foregoing affidavit was acknowledged before me on 1�,,
thea1o� n d day of
/
(month, year) by , Y 1 CAA aj " RD
for the purpos6 therein set forth.
Witness my hand and official seal.
My Commission expires: OcC obpr a q I a bl �
Permit #
O/iice use only
r
is
(NARY RICHLING
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19914001245
illy COMMISSION EXPIRES OCTO8E A2018 1