HomeMy WebLinkAbout151 S College Ave - Affidavits/Owner Authorization - 08/06/2019Planning, 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) �sl v� ��SL ur'�/ as owner of record (property
address) �S� /i>/./�� �lvf . known as (name of
business) r'yi✓ 0'j hereby authorize the
work listed below to be done on said property. I understand that such work will only be
per'''formed contractors licensed by the City of Fort Collins.
Y] I am giving permission for interior work only. The scope of the work shall be
/\ limited to: � e'u40 a o✓L-
❑ 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 :
Pro erty owner signature)
OL
(Property owner name; please print)
The fore oing affidavit was acknowledged before me on the. day of
(month, year) by
for the pur a therein set forth.
Witness my hand and official seal,
My CEsTATE
�V HILL
Y PUBLIC
COLORADO
9874089468
E Ires 01125020
Permit #
Office use only
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