HomeMy WebLinkAbout639 S COLLEGE AVE - AFFIDAVITS - 9/26/2014Fort
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) as owner of record (property
address) Av-e, known as (name of
business) �o i4q c � 3 el Z-G e 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:
lid I am giving permission for exterior work only. The scope of the work shall be
limited to: iripwor/d 0 r4 Ji5 120s n.( D t pnj'A f &'(4e
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to :
m (' K+,'m6erllq i- t�t e.l ,Cho 4-N
(Prop y owner ig ture) (Property owner name; please print)
The foregoing6 affidavit was acknowledged before me on the _ ) (�& day of (�
S2 A�lYtac�P 41 (month, year) by V 41'L
for the purpose therein set forth.
Witness my hand and official seal.
My Commission expires: 0' 3i 17
Permit #
Office use only
Ndtat)&Public
NICOLE JAVERNICK
j NOTARY PUBLIC
STATE OF COLORADO
yr NOTARY ID 0 20054030527
1 MY COMMISSION EXPIRES AUGUST 03, 2077