HomeMy WebLinkAbout914 S COLLEGE AVE - AFFIDAVITS - 2/15/20051 i
Community Planning and Environmental Services
Building and Zoiung Department:
City of Fort Collins 80 0672-
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print)j( as owner of record ro e
(P P rtY
Address) 9/4Z 15. zklpsr 44:r- known as (name of
business .P�1�/�j( �hereb authorize prize 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
to
/I am �qjv!pKq p i'sslo f r exteri rk ly. e e of theto Po sh I be IJ ted
gc /z.Y.9
0 I am giving permission for interior and exterior work. The scope of the work shall be
limited to
(Property 6wner signature)
The f e oing affidavit was acknowledged before me on the �J~
J5 (month ear p D .�: ^ �A D day. of .
for the purpose then
t forth. �Y ) b Y l-�
Witness my hand and official seal.
My commission expires: 31Z 0ln --�
Notary Public ;
Permit 0
(office use only)
281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6760 • FAX (970) 224-6134