HomeMy WebLinkAbout4235 S College Ave - Affidavits/Owner Agent - 03/07/2018Fort 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) WAU-S-vxwror oPh as owner of record (property
address) 4235 S College Ave, Fort Collins, CO 80525 known as (name of
business) 6WL-6ehvi55 iiLA Ar lzn�417Lo 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
0 I am giving permission for interior and exterior work. The scope of the work shall
limited to :
rJt4w,- 6• S • c .•7ti
(Property'pwnername; please print)
CN l��
The foregoing
affidavit was acknowledged before me on the j� aa day of/� ►� ,�
V / f l''TI� 64 (month, year) by F't2,�nJ lV. 5660 160
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: (//,Z?/6
Permit #
B1801584
Office use only
.- A
Dill MAUDCCMI
NOgryi,Milt . Arliom
Mwleo" County
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