HomeMy WebLinkAbout2720 Council Tree Ave - Affidavits/Owner Authorization - 07/10/2018City of
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) =R4\,0,0 7 ,Cy %, a�cf15D11 � L as owne�of record (property
address) 7L I ZC1 c! nk` ILT«g AQS * 11 7-, known as (name of
business) 19,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.
XI am giving permissionforinterior work only. The scope of the work shall be
limited to: 'hit 6XIl EQ AMAS'(84T �4,44
❑ I am giving permission for exterior work only. The scope of the work shall be
limited
�4eI am giving permission for interior and exterior work. The scope of the work shall
limited to : I rl� r-
Agent for MCo
CA
(P a owne igaat re)
(Property oivn .r name; please print)
S►w��lE-
The Foregoing affidavit was acknowledged before me on the %d� delay of
( 6 (month, year) by
for the purpose th In set forth.
Witness my hand aroRffll'l i4WIWINNEGA
Not ry Public, State of Michigan
My Commission expiress�ounty of Oakland
M�y.Co rnissionEx ires09.17-2023
U �'U in tfi� Co, 13nt�j.9f Q /dD _
e� � No*utl
Permit #
Office use only