HomeMy WebLinkAbout4501 VISTA DR - AFFIDAVITS - 9/8/2003L..�}111.C11C11'Ll�}/ 1'�I LTIIl1-1L���]J,'1.1'0411J1�'lltn_�
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HOMEOVv!N'ER/ BUILDER rIFFID-AVIT
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Fort Collins, Colorado, hereby declare aril attesL tc,
the foii�i/,rrnci: (',D se Chet'A, S or C,
A. :I an -I; v/e are acting on my/our behalf for thi purl:)osc of obtaining a building I_,c - it and
personally constructing my/our hon-ie. The home to b,_ Corr strutted is 01-1 ti-ICabove property and
Will be n-ry/our prin-rary residence. I/vve have not personally constructed any other new hon-re in Fort
Collins city limits within the past 24-month period.
B. I an-i/we are acting on my/our behalf for the purpose of obtaining a building permit and
personally/ constructing an alteration or addition to my/our home. The home 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 of obtaining a building permit and
personally constructing a non-structural alteration to my/our attached singie family dwelling
unit. The home to be altered is our personal residence. I am aware that I/we cannot do any
structural, electrical, plumbing or mechanical work. 1/we must Fire contractors/subcontractors who
are currently licensed with the City of Fort Collins.
I am/we are personally performing all of the work:, or will be continuously 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 persons or agents contracted to perform structural wood -framing,
plumbing, HVAC, electrical work, roofing or cast -in -place structural concrete work, MUST SE licensed
contractors in accordance with the regulation of the City of Fort Collins,
1/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 Work Order and a court summons.
Sign in the pr Bence of a Notar)l Public
LO WIA,
Ow r Owner
The foregoin Affidavit was acknowledged before me on this 1S " � day of
057 (month, year)by r-P5zk 01�A a V/,o�
Vditness my hand and official seal
1111�/ commission expires:
My Commission Expires
06/28J2006
Public
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