HomeMy WebLinkAbout3665 John F Kennedy Pkwy - Affidavits/Owner Authorization - 02/19/2018Fort Collins
Planning, Development & Transportation
281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
a.1_c; ."rY r"64 ce f'aI ) I%�-
s owner of'record (property
known as (name of
business) LAn A�c- Ln (Prd P/ 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.
Its 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
limited to :
e
(P&Ohyowner signature,11�`
work. The scope of the work shall
(Property owner name; plea pnnt)
The foregoing affidavit was acknowledged before me on the day of
Fe6ru,,an170 IV (month, year) by
for the purpose t erein set forth.
Witness my hand
My Commission e:
` P J?ol q
BRME M. TAMLIN
NOTARY PUBLIC
STATE OF COLORADO
NOTARY 10 # 200340072.4
Notary
Permit #
Office use only