HomeMy WebLinkAbout4700 BOARDWALK DR - MISCELLANEOUS - 4/29/20086ti Community Planning and Environmental Services
11 Fort Collins Neighborhood & Building Services
cI ,of fort Collins 281 N. College Ave., P.O. Box 580; Fort Collins, CO 80522-0580; Voice: 970 221 6760 FAX: 970 224 6134
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) Shannon Jemlcan on behalf of Sam's West. Inc. as owner of record (property
Address) 4700 Boardwalk Drive, Ft. Collins, Co 80525 known as (name of
business) Sam's Club 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.
m I am giving permission for interior work only. The scope of the work shall be limited
to Installation of a 3 dimensional floral case and reolacement of concrete slab.
❑ 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
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I for the purpose therin set forth.
Witness my hand and official seal.
My commission expires: qyzul
I ;2410
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Notary Public
Permit #
(office use only) CARMEN S. PETERSON
Notary Public, State of New York
No.OIPE4966281
Qualified in New York County
Commission Expires May 7, 2010