HomeMy WebLinkAbout1501 N College Ave - Affidavits/Owner Authorization - 06/15/2016i1'ot
Planning, Development & Transportation
281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-604
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) 10 v r��� as owner of record (property
address) D ] l.1jIler e— Xi--e known as (name of
business) Co '�1 C J 6 rZ 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 I am giving permission for interior and exterior work. The scope. of the work shall
limited to : 4/0(4)Y,d*wny'd'G7l�ia-
75rope.-ty owner signature) (Proper, owner name; please print)
The foregoing 2f9davit was acknowledged before me onthe�S� _daoy of r
(month, year) by 1 r owyq-S E✓COI GIL ovef4on
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: 5—I— o10t,
Not y Public
Permit
Orr ,
ANN KLAPPENBACH
NOTARY PUBLIC
STATE OFCOLORAW
NOTARYOM08901M