HomeMy WebLinkAbout120 W Stuart St - Affidavits/Owner Authorization - 01/30/2019City of
�FF6rrt Collins
Planning, Development &Transportation
281 N. College Ave P.O. Box 580
Fort Collins, co 80524
Phone 970-416-2740 Fax 224-613
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) ACL OP (FFt- Co Le.i1S ) L C— as owner of record (property
address).120 W Stewart Street, Fort Collins, CO 80525 known as (name of
business) 5-,4ibr P-0-- LO"IiIJS 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:
53" I am giving permission for exterior work only. The scope of the work shall be
limited to: j* of Aw ovrl)o'M Pare Mr•Ch rt5*
Tive Lax,6l -96 /rppf-v�
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to :
(Property owner signature)
,FCC 0P(FcfzrC0w&'S� LLL
,je,nt-e, G. liqI(e, ap
(Property owner name; please pnnt)
f�
The foregoing affidavit was acknowledged before me on the ® day of
JJ G-/ oAr4 , A-0 t� (month, year) by
for the purp# therein set forth.
Witness my hand and official seal,
My Commission expires: I&A--1 1 S, Zo Z
/KAJ,
Notary Public
Permit #
office uSeonly KARENLWILSON
Notary Pubfic. State of Texas
s M� Comm. Expires 03-19-2021
.;;o ; Notary to 12935277.9