HomeMy WebLinkAbout328 REMINGTON ST - AFFIDAVITS - 3/3/2010Fort Collins
Planning Development & Transportation
281 N College Ave P 0 Box 580
Fort Collins CO 80524
Phone 970 416 2740 Fax 224 613
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I (Print) JaSo^ I"tca^ol' CA�N'�a nl.,CFC, i c as owner of record (property
address) 328 Co g6521 known as (name of
business) Mom^ ^U0-r %ow�u^:�, C •� �����l�s 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 to
I am giving permission for interior and exterior work The scope of the work shall
limited to
S� (,roo I w-� (O•�-,-ofl r— spice 5
(Pro weer sign tore) (Property owner name p ease pant)
The foregoing affidavit was acknowledged before me on the � day of
m t 1
Wb Much , aid (month year) by \ la,SDn k Ivy( 61�Cli�a�
for the purpose therein set forth
Witness my hand and official seal
My Commission expires
Permit # 81001
Office use only
MICHELLE L
y, MEIS
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QSSi12 IRESNOtaty Public M
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