HomeMy WebLinkAbout639 S COLLEGE AVE - AFFIDAVITS - 11/3/2014Planning, Development &Transportation
281 N. College Ave R0. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-613
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�0 4 _ `c G- OWNER
AUTHOR17—ATION TO OBTAIN A O g ` R 4 i.
BUILDING PERMIT
I, (Print) S ILI. &AIda—ti as owner of record (property
address) (�3gsOyfh �a/(�� �rf (,g&As known as (name of
business) So ug Goir!¢� LLC 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 worst only. The scope of the work shall be
limited to:
❑ I am giving permission for exterior worst only. The scope of the work shall be
limited
V/I am giving permission for interior and exterior work. The scope of the work shall
limited to :
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(Pro ertyownersignature)
( Property owner name; please print)
The
' foregoing affidavit was acknowledged before me on the J� r� day of
/V QVC.{' hEit:F ,-20 (month, year) by MG2('.� �� [a
for the purpose therein set'forth.
Witness my hand and official seal.
My Commission expires: klpri I if , 0201 `i
Permit #
Office use only
dANFLLE STULTS
NOTAR`f PUBLIC
STATE OF COLORADO
NOTARY ID 200 4012518
MY.COMMISSION EXPIr S APRIL 2t, 2017 _\