HomeMy WebLinkAbout424 PINE ST - MISCELLANEOUS - 3/19/2008Community Planning and Environmental Services
Building and Zoning Department
a
t.
City of Fort Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) —70w P . (A • L a ryeP as owner of record (property
Address) q;-`1 ANlf, • Sl li 100 known as (name of
1'_ (� FUG-- Cho CO 80szy
business) 'lam 1jkd ► `Qi� CQ� �Pf*r hereby authorize the work
listed below to be done on said property. I understand that such work will be
performed only by 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 re odd)ehq o� (+,(6issryom -fo Serve-.- iY} r,71s
❑ 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 be
limited to
( a�mz �Y-, Aw.,co--
'--tKoperty owner signature)
The foregoin affidavit was acknowledged before me Rn the — 6� �—� day of
m b'Cl( a60'6 (month,year) by LTV 1k NL. LculC114!
for the purpose therin set forth.
Witness my hand and official seal.
My commission expires:
Permit
0 Notary Public
801742
(office use only)
281 North College Avenue A PC. Box 580 • Fort Collins, CO 80522-0-580 m (970) 221-6760 , FAX (970) 224-6134