HomeMy WebLinkAbout404 N College Ave - Affidavits/Owner Authorization - 03/14/2018City of Planning, Development & Transportation
F6rt Collin 180
8 0 For N. College Ave
o � ,� � Fort Collins, CO 80524
(. Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) JA-AAES e- .A-43607F as owner of record (property
address) y00 /J . r?eq LL�6E k—F known as (name of
business) EXc-si. s i oR. d E",F-12 41,C_ 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.
g I am giving permission for interior work only. The scope of the work shall be
limited to: BA-Sem F-m ,1 Dt 11i imk WAu s >-PC61LS
❑ 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 :
FF,
l�i�arr��
AM 0417-
(Property owner name; please print)
The foregoing affidavit was acknowledged before me on the da of
MOAiG k / 20 l v (month, year) by -TQ 4A.65
for the purpose therein set forth.
Witness my hand and official seal. My Commission expires: 53l D a/Zcz
Permit #
ice use only
Ai15TIN MILLER
Notary Pul,Iic -- State of Colorado
Notary Q) 20174010491
My Commission Expires Mar S, 2021