HomeMy WebLinkAbout832 E Lincoln Ave - Affidavits/Owner Authorization - 01/10/2018City of
Fort 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) bsi ulbe+,P oPedA LLC . as owner of record (property
address) L / 5�`Pi(N/Qd known as (name of
business) ✓ U� 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.
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I am giving permission for interior work only. The scope of the work shall be
limited to:
for exterior work only. The scope of the work shall be
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❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to
(Pr petty owner signature) (Property owner name, please print)
The foregoing affidavit was acknowledged before me on the day of
`, A (o (month, year) by I OL fflQ'0__J-e cul
for the purp a therein set forth.
Witness my hand and official seal.
My Commission expires: al3 I lap 1
Xb� lublicPublic
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18: N 0 114 6.
Permit # I LISA R LABRACKE
0J9`ice use only NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20134080415
MY COMMISSION EXPIRES DEC. 31, 2021
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