HomeMy WebLinkAbout606 RAMAH DR - AFFIDAVITS - 7/14/20031-111-1 Ll FJ.�-,t, l'�. 1 rtt ,I�J LI r ,j,
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HGI,ftE0V_/1:ER/EUILDER r.FFID4,.\TIT
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yl bbc' Zhnah Drl Q (2 Folt Collins, Colc,rado hereby declare and attes tc,
(please print
the f011ovqjrlqPIEc 35c C%/?f); A,f' or
J aurri/ vuee Lire actinci on n-,y/our behalf for th,e purpose of obtairIir,g a building) prmit au-Icl
personally constructir+c n-1y/our i tong_. They hDri-ie to b_ constructed is on tl-lc above 1_,ropert� and
Will be n_t�i/our prin-iary residence. have not personalk, constructed Elf-)V oti-,er rJeW homE irl Fort
Collins city limits within thEt past 24-month period.
B. I an-i/vie are acting on my/our behalf for tl-te purpose of obtaining a building pern-iii and
personally constructing an alteration or addition to my/our Home. The hon-ie to be altered is on the
above property and is my/our personal residence.
❑ C. I am/we are acting on my/our behalf for the purpose or" obtaining a building permit and
personally constructing a non-structural alteration to my/our attached single family dwelling
unit. The home to be altered is our personal residence. I am av,are that I/we cannot do any
structural, electrical, plumbing or mechanical work. I/v�!e must hire contractors/subcontractors who
are currently licensed with the City of Fort Collins.
I am/we are personally performing ail of the work, or will be continuously supers/ising unpaid volunteers:
The worl,, is directly related to t c sy c - n P v eferenced home, which is described more
` f
fully on Permit application (obtained from Building and Zoning
office). I/vVe understand that any persons or agen s contracted to perform structural wood -framing,
plumbing, HVAC, electrical vvork, roofing or cast -in -place stru2tural concrete work, MUST T B= licensed
contractors in accordance with the regulation of the City of Fort Collins,
I/vie understand that failure to comply v�lith 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 Wort: Order and a court summons.
Sign io the presence or"a IUota,�/ Public
Ov�hner
Owner
e foregoin Affidavit vdas acknowledged before me on this �7� day of
(month, yearjby —T��_- P {-1p�j-1
Witness my hand and ci iicial seal
lily commission e>;pires-
My Commission Expires
11/1Q12006 I`Jotary' Public