HomeMy WebLinkAbout914 S COLLEGE AVE - AFFIDAVITS - 1/16/2004Coininunity Planniiia anti Environmental Services
Building and Zoning Departmeni
B0400242
City of Fort Collins
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) �; ,��-r,3� �, u6 Aj IZA � , _�; ra owner of record (property
Address) J/y Sa. «� «E4VC known as (name of
business) D ES r s i-78: k -'U au i y RE Rs r 7 7 Z; ahoeby 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.
o I am giving permission for interior work only. The scope of the work shall be limited
o 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
S^J>^I— 4Rv tA 6 "*t jA UEST"t��s
(Property owner signature)
The forgoing affidavit was acknowledged before me on the
s' day of .
(month,year) by
for the f5urpose therin set forth.
Witness my hand and official seal.
My commission expires: 31Za/06
Notary Public
Permit #
(office use only)
2S1 North College Avenue • P.O. Box 58o •Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134