HomeMy WebLinkAbout914 S COLLEGE AVE - AFFIDAVITS - 1/19/2016o g �� r�•s
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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)2J S ; p:,l , Incas owner of record (property
address) AyE. known as (name of
business) &Fs-r k%/,-.sram,,, aAJ1VFLZ.5r-ry 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
hf scope of the work shall be
limited to: Wrfrb•&v Alt4P Fy4c.�1>� (�lPGie,4�Es
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to:
fr
(Pro -owner signature) (Property oname; please pirnt)
The foregoing affidavit was acknowledged before me on the / % �� day of
:1:�-(montli, year) by �..
for the purpose erein set forth.
Witness my hand and official seal.
My Commission expires: IAA /P/.o/p
B 100 0 2-3-0
Permit # e 0 0 0 Z
Ofte use only
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Notary Public
DONNA 8&H--L D
NOTARY PUBLIC.
STATE OF COLORADO
NOTARY ID 19944018489
MY COMMISSION EXPIRES 1Zl18/Z018