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HomeMy WebLinkAbout416 FRANKLIN ST - AFFIDAVITS - 7/22/20116//415)3-73&7- C[t r`cf, )•. Collins ^1Jlf• ASS ••� •I•••. Plahning Development and Transportation PO BQx;80<< 2'$1 N5 College Ave Ft ColCri's;, CO `60k4 - 97©-2.1,4760 phone 970-22* 6134 fax I/we, lgw� 'TowNe as owner(s) of recard"of the property located. At: LK 6 &r\kUh Si - , Fort Collins, Colorado, hereby declare and attest to the following: (please check only the one that applies) Q 1 arrV we are acting: on my/ our behalf for the purpose -of obtaining' a buildng:permit and personally constructing my/our home. The home to -be. constructed is orr,tl a above property and will be my/our primary residence. [/we have not personally constructed nay other new homes in the Fort Collins city limits Mthin-the past-•24}month-period. C] I am/we are acting on my./our behalf for the-' - u . o e,.of. o iainirig a k .. P ►P s .b .. y. dq .g permit ands personalty constructing an alteration or addition to my/our house. The house to be altered is on the above property and is my/our personal residence. ; 0 a Vwe are- acting on my/our. behalf for the purpose'bf`obtaining a cuild<ng permit and personally consthx. ting anon=structural alteration- to my/our stfacf`ied single familydwelling ur - The:house to be altered is my/our personal residence. f am aware that Uwe canrtbt da any streicttiral; electrical, plumbing: ore mechanical-'and'must hire-'coritrd6tors/subcantractors who are currently licensed and insures with the City of Fort Collins, I am/we are personally performing all of the work, or will be continuously supervising unpaid volunteers. The work is directly related to the construction of the above 'referenced home; tn"rliich is described more fully on Permit Application # (obtained from Building and Zoning office). I/we understand that any persons) or agent(s) contracted to perform, structural wood -framing, plumbing, HVAC, elect work, roofing pr cast:in place structural concrete:work, MUST BE-icensed_contzactoKs-inw - _---_ Uwe 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 of any fees that have been collected, a Stop Word Order and a court summons. Sign in the presence of Notary Public /e ner Co-owner Time foregoing Affidavit was acknowledged before me on this �`- day of jcx0 (month, year) by ' ran n c Jia1 ,� _.....eau,...._ MJitness my hand and official seal tiOTAp), My commission expires: :• ptveLlG Notary Public