HomeMy WebLinkAbout914 W LAKE ST - AFFIDAVITS - 12/20/2011Fort Collins
Planning, Development & Transportation
281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) (9 0-- 0 ('Zz LL e as owner of record (property
add
known as (name of
business) RAM S CgOSSU'46- KZ hereby authorize the
work listed below to be done on said property. I understand that such work will only be
performed contractors licensed by the City of Fort Collins.
❑ I am giving permission for interior work only. The scope of the work shall be
limited to:
❑ I am giving permission for exterior work only. The scope of the work shall be
limited to:
XI am giving permission for interior and exterior work. The scope of the work shall
limited to :
(Property own name; please print)
The foregoing affidavit was acknowledged before me on the day off
(month, year) by )
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: 3l11 l "-?0` t
47 z
.„
R41