HomeMy WebLinkAbout425 W MULBERRY ST - AFFIDAVITS - 11/16/2010Nov-16-2010 01:53pm From -GROUP HORSETOOTH
+9702232999 T-282 P-002/008 F-605
C0 =unit37 Planning and Environmental Seryices
Building and Zoning Department
111 i',1 1 011, dl^
Oallk 74
OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL BUILDING
PERMIT
I, (Print) ?M u r t,3 Fvt (2 Y .0 f s -7 1 L_ 10 as owner of record (property
Address) 5- "uc -, ,77 5 iiL -� !TC.:"l as (name of
business) MVi kzdrc % &���ss,� �Ac o� «hereby authorize the work
listed below to be done on said property. I understand that such work will be
performed only by contractors licensed by the City of Fart Collins.
XI am qving permission For interior work onl . T e•scope of the work shall 4e limited
to �i' • n 'r ►1
421 r IN JyL�1A!
❑ 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 be limited to
�'V1ULFj�d'�Y w�s7 LG �
(Property owner signature)
Tine foregoing affidavit, was acknowledged before me on the /fir day or
No (mhC9. �Lo10 (month,year) by i � for the purpose
therm set forth
Witness my hand and official seal. ��� Q?�'•~G��'�
f �.10Tg9 ` r
My commission expires: F/ ZU zo i K = CD:
o UBLIC
F'• ' o�:
,s�'<pF C01-
261 NOMI u—Nge Avenue • P.O. Box 580 • Ton Coping CO 8Dti?.'--05Bo (y7o)zzn.-s76o • i i� (y :�zf` P . `��, V