HomeMy WebLinkAbout913 VANDERBILT CT - AFFIDAVITS - 7/18/2011Clay Of
;• =t Collins
Planning; Development and Transportation
Po Box 580<q
281 N College Ave
Ft Cotkh-s C0 80524'
970=Z21-676,0 phone 970-224-6134fax
I/we,as owner(s) of record of the property located'
At: �J Cfi Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies)
❑ I.amV.We are acting on my/ our�behalf for the purposeoflobtaining a, building permit and personally;
constructing my/our home. The home to;be.constructed is `on ithe..above--property and will be my/our
primary residence. I/we have not personally constructed nay other new homes in the Fort Collins
city limits within the past.244nonth-period.
I am/we are acting on my/our-behalf for the purpose of obtaining -..a building' permit ands personally
constructing an alteration or addition to my/our house. The house to be altered is on the above
pro erty and is my/our personal residence.
J� ain/we"are I acting. on my/our-behalf for the purpose of obtaining a building-permit:•and;personally
constrructing a non-structural alteration to my/our'attached single'family dwelling unit. The house
#-to be altered is my/our personal residence. I am aware that I/we` cannot dd'any structural;
electrical, plumbing`•ore mechanical'work'andmust Hire•contractors/subcontracfors'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 relate the construction of the above referenced home, which is described'more fully
on Permit Application # �j 1 l b 3 5 a a (obtained from Building and Zoning office). I/we
understand that any person(s) or agent(s) contracted to perform, structural wood framing, plumbing,`HVAC',
electdcal.wo.rk, roofing,or:cast-in7place structural concrete work, MUST BE licensed contractors in _
CLL,1.U1 UQ111,U VVILI I U IG' IC.1�. UICLUU1 I W1 LA Ic VILY LJI 1 LJt L VVIIII IJ.
/we 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.
1
Sign it the presence of Notary Public
Owner Co-owner
The foregoing Affidavit was acknowledged before me on this / day of
l/ (month, year) by ittSS
Witness -my hand and official seal
my com io�l sNO � 4
I �00
Notary 'Pub c