HomeMy WebLinkAbout4112 MOUNT VERNON CT - AFFIDAVITS - 9/2/2010C of Planning Development and Transportation
,e.} Col`i n C PO Box 58Q -
J 281 N College Ave
Ft Collins CO 80524
970 221 6760 phone 970 224 6134 fax
Uwe LkQ las %1�� I rn ��►�o�� �p cwrer(s) of record or d-,e property located
At Ml ukrnon Ct < Fort Collins, Colorado hereby declare and attest
to the following (please check only the one hat applies)
O 1 am/ we are acting on my/ our behalf for the purpose of obtaining a building permit and personally
constructing my/our home The nome to be constructed is on the above property and will be my/our
primary residence I/we have riot personally constructed nay other new homes in the Fort Collins
city limits within the past 24-month period
Cl I am/we are acting on my/our behalf for the parpcse of obtaining a building permit and oerscnaily
constructing an alteration or addition to my/car house The house to be altered is on the above
property and is my/our personal residence
1 am/we are acting on my/our behalf for It a purpose of obtaining a building permit and perscnally
constructing a non-structural alteration to my/our attached single family dwelling unit The house
to be altered 1s my/our personal residence I am aware that Vwe cannot do any structural,
electrical plumbing ore mechanical wor`R and must hire cortractors/subcontractors who are
currently licensed and insures with the City of Fort Coins
I am/we are personally perform, ing all of the work or will be continuously supervising unpaid volunteers
The work is directly related to the ristructicri et the above referenced home, which is described more fully
on Perm, Application # I�� � � ff A f (obtained from Building and Zoning office) Uwe
understand that any persor(sPor agent(s*contracte o"perfom structural wood -framing plumbing HVAC
electrical work -roofing orcast in -place structural concrete work, MUST BE licensed contractors u1
accordance with the regulation of the City of Fort Collins
Vwe 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 fcrfedure of ary fees that have been
collected a Stop Work Order and a court summons
S yin .e preserve of Natar PJb(rc
Owner co- ner
Tne foregoing Affidavit was acknowledged before me on this 2
sn
l / day of
sen1�e^,Je4' 2-010(mcrth ysar) by a���J 9 Slfi /I/Lv✓�i'�
Wkness my hand and ofriclal seal
Mbj commission expires -?/ 9/20 1-2
CRAIG EPP
NOTARY PUBLIC
STATE OF COLORADO
My Commission Expires Mar 19 2012
Z I
Notary41-