HomeMy WebLinkAbout6400 SOLAR CT - AFFIDAVITS - 7/27/2011C OF6 L / Plannin�,-Develop ent.arSd Transportation
PO Box 580,
Flirt Collins 281.N College Ave
Ft Collins, CO 80524
970-221-6760 phone 970-22476134fax
/we, %�- _ _ - , as owner(s) of record of the property located
At: %��� !yY� L¢� �► , Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies)
❑ lam/ we are acting on my/ our behalffor the purpose of obtaining a building permit and personally
constructingmy/our home. The home to be constructed is on the 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 24-month period.
I am/we are acting on my/our behalf for the purpose of obtaining a building permit and personally
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.
O 1 am/we are acting on my/our behalf for the purpose of obtaining a building permit and personally
constructing 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 do any structural,
electrical, plumbing ore mechanical work and must hire contractors/subcontractors 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, which is described more fully
on Permit Application # (obtained from Building and Zoning office). Uwe
understand that any person(s) or agents) contracted to perform structural wood -framing, plumbing, HVAC,
electrical work; roofing or cast=in-place structural concrete work, MUST BE licensed contractors in
accordance with the regulation of the City of Fort Collins. . .
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
Co-owner
The foregoing Affidavit was acknowledged before me on this -_ day of
...:�•.. (month, year) by Ae�i<��1,.
Witness ec
My com iss�on expires:
o� :.
otary u lic ..