HomeMy WebLinkAbout932 W DRAKE RD - AFFIDAVITS - 12/22/2009Community Planning and Environmental Service
Fort Collins Neighborhood & Building Services
�_� �,r b��•„�i,l,b 281 N. College Ave., P.O. Box $80, E ort Collins, CO 80$22-0580; Voice: 970 2216760 FAX: 970 224 6134
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) Lonq.,4 Dr �e ep C as owner of record (property
Address) known as (name of
business) __l v2�2 oI 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,
X I am givi q permission for interiorJJworr only. Th/e� scope of the
work shall be limited
iw --/
❑ 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
(Pro owner signature)
-'ih�'e�Q regoing affidavit was admowledged before. me on the 0 day of
�i�, (, ,� h c " , , �.> ( (month,year) lay '� ' . a No r I (fh
for the purpose therin set forth.
Witness my hand and official seal.
My commission expires:
Notary Public
A'VM ' 09 o 111, 2M
(office use only)
p,wn M Nlard
Notary pubk
State of RhodeIrssland
0612212011
pqy Commission CxP