HomeMy WebLinkAbout912 WOOD ST - AFFIDAVITS - 6/15/2015City of Planning, Development & Transportation
F��" Collins For N. College Ave
Fort
'°.— Collins, CO 80524
�1r Phone 970-416-2740 Fax 224-6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print) Fa-reszos GTLEEIc pF ei-apmayr We—, as owner of record (property
address) woos ST¢.EET known as (name of
business)
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 : N A,
( owner sign re)
P0.�eroa Ch•�,�C.Os+vn(.cPv..��rK � )
Q No CA14PAAIA
(Property owner name; please print)
The foregoing affidavit was acknowledged before me on the I5+ day of
JUtyy I 2015 (month, year) by (S n o 006119a ocn
for the pur op se therein set forth.
Witness my hand and official seal.
My Commission expires: 0%1171Z01-7
Permit #
Office use only
JENNIFER FELLINGER
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20044044223
MY COMMISSION EXPIRES 07/1712017