HomeMy WebLinkAbout809 ROMA VALLEY DR - AFFIDAVITS - 1/18/2013-
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to the following: (please ch&e6nly the one tint applie
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❑ 1 am/ we are 9cting on m / our beha'ffi for the pu
m
constructing my/our•hom?. The hoe jp be coi
primary residence. I/we have nb�personally, co
city limits with irr the- past24-month period.
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I am/we are acting o' .y/oej'r butt, all fdptdle pb
constructing an alteration or addition to my/our
property and is my/our °personallr�sldean ce..
Planning, Development and Transportation
PO Box 580
c, 281"N College Ave
FL'Cotlins, CO 80524
"970-221-6760 phone 970-224-6134 fax
FFI DAVIT
as owner(s) of record of the property located
ort Collins, Colorado, hereby declare and attest
of obtaining a building permit and personally
ed i� on the above property and will be my/our
ted nay other new homes in the Fort Collins
obtaining a building permit and personally
The house to be altered is on the above
❑ 1 am/we are acting on my/our behalf for the purge of obtaining a building permit and personally
constructing a non-structural alteration to my/bur attached single family dwelling unit. The house
to be altered is my/our personal residence. I a are that I/we cannot do any structural,
electrical, plumbing ore mechanical work an`m,s hire contractors/subcontractors who are
currently licensed and insures with the City of Fort Collins.
I am/we are personally performing all of the work, or will be'Antinuously supervising unpaid volunteers.
The work is directly related to the construction of the above referenced home, which is described more fully
on Permit Application # (obtained from Building and Zoning office). I/we
understand that any person(s) or agent(s) contracted to 9perform structural wood -framing, plumbing, 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 C&Iins.
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 Word Order and, a court summons.
Sign in the presence of Notary Public
0
Owner
The foregoing Affidavit was acknowledged before M
X (month, year by
Witness my hand and official
My commission expires:KAREN .
THARP(� ,�'/ice
Notary Public
MY COMMISSION EXPIRES:
July 23, 2015