HomeMy WebLinkAbout932 W DRAKE RD - AFFIDAVITS - 12/22/2009 (2)Colmmunitr Planning and Environmelita/Se/vicas
Fort Collins Neighborhood & Building Services
281 INCollege Ave r o Box $80 Fort Collins CO 80$22-0580 Voice 970 2216760 FAX 970 224 6134
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I (Print) La na.,4 Dr re,e4�' e— as owner of record (property
Address) LJ known as (name of
business) :L; Lr4 o 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 gi!�q permission for Interior work only The scope of the work shall be limit,
o 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
4( owner signature)
,--'The on, affidavit was acknowledged before me the �I `� dayof{
c o t 1 (month year) by
for the purpose eterin set forth
witness my hand and official SWI
My commission expires —
�!_�
R 0 2 �,JNotary Public
9 Dawn M Allard
AemJ�t wo N tart �ubllc
(ofCce use only) State of Rhode Island
MY Cmmisslon Expires 06/2212011