HomeMy WebLinkAbout114 N COLLEGE AVE - AFFIDAVITS - 4/19/2017Fort Collins
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,
business)
Obfer-11
owner of record (property
III V J NorT� Coreye he J �F ���(6i `zI known as (name of
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`�enan � PL l5� LAn
( onS1rNcTion or coo+,ncrl;o c0o/I,
❑ I am giving permission for exterior work only. The scope of the work shall be
limited
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to
IeY' -a --h eaAS
Ityrty
owner s1 nature (Property owner 4a00 please pent)
The foregoing affidavit was acknowledged before me on the �_ day of
11
or. Z01 -9- (month, year) by P�'a- qA 5
for the purp se therein set forth.
Witness my hand and offs a sea . BROOKE M. TAMLIN
NOTARY PUBLIC
STATE OF COLORADO
My Commission expires: NOTARY ID 0 2003400
MY COMMISSION EXPIRES AP L 11, 20
Notary ublic
Permit
Ofce use on/y