HomeMy WebLinkAbout914 S COLLEGE AVE - AFFIDAVITS - 5/20/2004City of Fort Collins
Community Planning and Environmental Services
Building and Zoning Department
004003-687
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
� t t3cc� &t L-4 t4 o k S
I, (Print) F3v 14 z x Lo C, K E 'i;_- as owner of record (property
Address) 4 I y Sd a;- z E 14 i(jE7known as (name of
business) _ � �- LJ s7- �,elv ,,,; R.1,7y T b reby 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 giving permission for interior work only. The scope of the work shall be limited
to
❑ I am giving permission for exterior work only. The scope of the work shall be limited
to
X I am givinZIle
.sio forinte ' r and a r'or work. o of the w rk shall be
limited to _t�'U S.0 �.e� �..J. _ L
(Property owner signature)
The for ping affidavit was ,acknowledged before me o the � day of .
affidavit
by
for the purpose erin set forth.
Witness my hand and official seal.
My commission expires: 31a05
Notary Public
permit`
(office use only)
281 North College Avenue - P.O. Box 580 - Fort Collins, CO 805��-0580 - (970) 221-6760 - FAX (970) 224-6134