HomeMy WebLinkAbout6915 Autumn Ridge Dr - Affidavits/Owner Authorization - 02/28/2019City of
Fart Collins
2 I C
Planning, Development & Transportation
281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) 4 l- Ale JbaNncen as owner of record (property
addreSS) 6915 Autumn Ridge Drive, Fort Collins, CO 80525 known as (name of
business) 2rall'l Ciao � � �Q' 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 to:
® I am giving permission for interior and exterior work. The scope of the work shall
limited to : Detach and reset cabinets, remove slab on grade, excavate, install structural slabs, and
replace finishes
4(prqowXneXrs!gn�atvre) (lYroperty owner name; please print)
The foregoing affidavit was acknowledged before me on the GAY__
day of
ry Zfilq (month, year) byK�ew
for the purpose therein set forth.
Witness my hand and official seal.
My Commission explres:a,.,x 23,Z�Zz
Not ubl
Permit #
office use only
AMANDA HOLSTEIN
Notary Public -State of Colorado
Notary ID 20184003735
My Commission Expires Jan 23.2022