HomeMy WebLinkAbout4700 INNOVATION DR - MISCELLANEOUS - 4/11/2006b4/ 12/ 1blJb 11: 5y y (11-282-1 btib HEAL I EU LUMMEHUiAL HAUE 02/ 02
&K-11-`wb "Wh Ub:44 AN MENIT LLEGIR10 FAX NO. 970 266 1640 P, 02
community Planning and Environmental Services
Fort Collins Neighborhood & Building Services
(:Iry dr(:Iry i It 281 N. College Ave., P.O. Box 590; Fort Collins. CO 80522.01. 0, Voice; 970 2216760 VAX: 910 224 6134
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PER MrT
I, (Print) 7D� .Lti �,�ue+��o✓I 46G . l�ey�e6 owner of record (property
Address) —"71%..-A Pi, ''c <,e, �4- T2 known as (name of
business)
hereby authorize the work
listed below to be done on said property. I understand that such work will be
perfernned 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
I'� �i o ✓ w� (,(S i'�l//f'C t (Gc c.��y✓s'J 11 c3 14�C S
v I am giving permission for exterior work only. The scope of the work shall be limited
to
a I am giving permission for interior and exterior work. The scope of the work shall be
limited to T
pertv owner signature)
The foregoing affidavit was acknowledged before me og the � � t1 tlay of
kP (month,year) by
forth a then n set forth, `40. � 11 S T 00,4
.,!
Witness mc�` "Ile
hand and afflcal dal.' ,. _ �,'%
My commisslon expires:
006015(
Permit A` �•`�••,.-
(ofece use only)