HomeMy WebLinkAbout114 BRISTLECONE DR - AFFIDAVITS - 3/31/2016F6rt Collins
Planning, Development Ili Transportation
281 N. College Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+6134
BUILDING OWNER AUTHORIZATION TO OBTAIN A COMMERCIAL
BUILDING PERMIT
I, (Print).4-a! & wkeftas owner of record (property
address) / / iv S ?.;T.,-,/c e.,.. known as (name of
business) 4-A147J i534 � L,. chereby 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:
# I am giving permission for interior and exterior work. The scope of the work shall
limited to :
/(Property owner signature)
property owner name, please print)
The foregoing affidavit was acknowledged before me on the t day of
(month, year) byni
for the purpose therm set fo-2rt—h RiVOYANIC
saa•ofcoromao
Witness my hand and official seal. Noes' 1D�'073e
FAY Commlgl- n Ex01=Novo, bw26,Yd18
My Commission expires:
No a Pub/ic
n'
Permit # , X=1\
Of oe us'on/y