HomeMy WebLinkAbout4809 S COLLEGE AVE - AFFIDAVITS - 11/17/2011t..C►t Planning, Development & Transportation
f -8 281 N. College Ave
Fort Collins, CO 80524
106221hone 970-416-2740 Fax 224-6134
BUILOING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print)
Kr ".s S
,S�d It 4 _
as owner of record (property
address)
Woe) �.
� 1/1 Y`i4ve--
known as (name of
business)
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& r r- Car j iZ5/1 G .
hereby authorize the
work listed below to be done on saki property. I understand that such work will only be
performed contractors licensed by the City of Fort Collins.
CI I am giving permission for interior work only. The scope of the work shall be
limited to:
0 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 soDM of the work shall
limited to : SWAJ ^
_ � � � ' 1�c1�, r1►�cinu,nlca�- v.n�����r;Dr1 _ �'i+��C y3r �4'�'+ f��
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(Progeny or ner,s/ynature) (Prow* a►mner AWIEV PAS PrjW
The foregoing `affidavit was acknowledged before me on the 1— day of
(month, year) by
for the purpose therein set forth.
wltn= my hand and official %eal,
My commission expires: 6 �
Permit #
Of a use ony
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