HomeMy WebLinkAbout4501 CLIFFSIDE CT - AFFIDAVITS - 6/23/20031111Lll!.:!'f"} I"1 !7lT'1111. Fil'td E:I'11'i.a"C 1"tIl CII�c.� er 1Ct:
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Ih 1�O�,at.n /U- ���,�eyrq� Llr, ov ner(s of record of the �ro_,ert
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C�i r - s�DF' �� Fort Collins Coloraclo, hereby declare and attest to
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tl le follovt,inq: (P/eese cfieJ, A, B or C
D A. I am/ we are acting on my/our behalf for the purl_,osc of obtaining a building permit and
personally constructing my/our honTle. The Home to be COnSt!"uCted is on the above property and
Will be n-ly/our primary residence. I/v>)e have not personally Const-ucted any Other rlew home in Fort
Collins city limits within the past 24-month period.
❑ B. I am/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 single 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. I/We must hire 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 supeniising 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, DUST BE 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 o aany fees that have been
collected, a Stop Work, Order and a court summons.
Sign in the pre nce of a Notar)l Public
44
Owner Owner
The foregoing Affidavit was acknowledged before me n this a 3 da f
_(month, year)by y
Witness my hand and official seal
icy commission expires: ,.
MYCMM"M Boras 01
1i/10/1006 Notary Public
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