HomeMy WebLinkAbout418 LINDEN ST - AFFIDAVITS - 5/16/2011City O
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Planning, Development & Transportationl
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281 N. College Ave
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Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) ':TNptAP%s C�iAOa�-���Xas owner of record (property
address) q\8 LAtZbEJ3 _,Zr. TM: C.cJJw riS; dQ Z64Sa known as (name of
business) �' IAkjt, "rnC . hereby authorize the
work listed below to be done on said property. I understand that such work will only be
performed 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
VI am giving permission for interior and exterior work. The scope of the work shall
limited to :
The foregoing affidavit was acknowledged before me on the 161 day of
(month, year) by
for the purpose therein set forth.
Witness my hand and official seal.
My Comm"
WENDY TJELMELAND
NOTARY PUBLIC, STATE OF`.COL.ORADO
Permit # MY Comm. Expires October 22, 2014
Ofte use only