HomeMy WebLinkAbout4307 CAPE COD CIR - AFFIDAVITS - 5/16/2007Community Planning and Environmental Services
-rr Building a ie, Zoning Department
IF r "
HOMEOWNER/BUILDER AFFIDAVIT
Cit`7 Of Fort Collins
I/we, tv\as owner(s) of record of the property located
(PleRs`_ print) .
at: y-;o-] r 0 r Fort Collins, Colorado, hereby declare and attest to
(please print)
the following: (please them; A, 5 or C, whichever aQpiies)
❑ A. I am/ we are acting on my/our behalf for the purpose of obtaining a building permit and
personally co,r.structing my/our home. The home to be constructed is on the above property and
will be my/our primary residence. I,/we have not personally constructed any other new home in Fort
Collins city limits within the past 24-month period.
B. I am/we are acting on my/our behalf for the purpose of obtaining a building permit and
personally constructing an alteration or addition to my/our home. The home to be altered is on the
above property and is my/our personal residence.
❑ C. I am/we are acting on my/our behalf for the purpose of obtaining a building permit and
personally constructing a non-structural alteration to my/our attached single family dwelling
unit. The home to be altered is our personal residence. I am aware that I/we cannot do any
structural, electrical, plumbing or mechanical work and must hire contractors/subcontractors who
are currently licensed with the City of Fort Collins.
I am/we are personally performing all of the work, or will be continuously supervising unpaid volunteers.
The work is directly related to the construction of the above referenced home, wnicn is described more
fully or, Permit Application 7 (obtained from Building and Zoning
Office). I/we understand tha e cn .r ge s ted to perform structural wood -framing,
plumuing, HVAC, electrical work, roofing or cast -in -.place structural concrete work, MUST BE licensed
contractors in accordance with the regulation of the City of Fort Collins.
I/we understand that failure to comply with any of the above conditions may result in revocation of
any permits associated with the above Permit Application number, forfeiture of any fees that have been
collected, a Stop Work Order and a court summons.
Sign in the present of a No ry Public
wner Owner
The foregoing Affidavit wwfa- U ,t6 Qed before me on this %% � day of
/ A,,j °,y ���\\r. �Ly(lionLPi"y�year)by V i kyl 6L�yU 0 A-wi MAc' It �-J3-f� L
w • l Q i.
Witness my hand anddgf�af s l z o
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My commission expiry =moo'.. *may ,
$ O 006 .
Notary Pub i
381 iworth Loliege :''.�-enue PO: Boa: �3U Fort Collins, CO 50523-0550 (970) ?2]-6?60 • FAX (970) 2_=6]34