HomeMy WebLinkAbout216 N College Ave - Affidavits/Owner Authorization - 08/06/2018City of
Fort 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) 216 N. College, Suite 130 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
® I am giving permission for interior and exterior work. The scope of the work shall
limited to : Per permit set of
owner signature)
Kevin Brinkman, Manager of Brinkman Entity Mangement, LLG
Manager of 200 N. Col e, LC 2 ,
(Property owner name, Please print)
The foregoing affidavit was acknowledged before me on the (n' b day of f &+ n) Q t � (month, year) by YA e C3 : a W : !1 yrn r ✓1. 1 1 /� (f A nUD 17 +�
for purpose therein set forth. f n�; zfn•*i�/ Muetc, errs G�-Cr
Witness my hand and official seal. �1V�y Cr cry a.) O 0, LU 1 ( e_�E', C
My Commission expires: RJ/a%30
Permit #�
Office use only
QPublic
DANIELLE M THOKE
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20124051476
MY COMMISSION EXPIRES AUGUST 16, 202b