HomeMy WebLinkAbout328 REMINGTON ST - AFFIDAVITS - 8/8/2017Fort 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, (Print) kt:z IL157 Odrm as owner of record (property
address) 7-4y' &0evy known as (name of
business) he authorize the
work listed below to be done on said property1 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
❑ I am giving permission for interior and exterior work. The scope of the work shall
limited to
(Properly
A. (-'-v 1��
(Property owner name, please punt)
The foregoing affidavit was acknowledged before me}ntonthe 0 _
day of
�^ fc W J l � 2011 (month, year) by 'i r 1Dt—::f?—lr: . �I
for the purpose therein set forth.
l _ '
Witness my hand and official seal.
My Commission expires:
s;: -
481L 7 0 4 3- 1
•-
e use only
ram,
Notary Public
MELISSA NELSON
NOTARY PUBLIC
STATE OF COLORADO
NOTARY 101120164010301
MY COMMISSION EXPIRES 03.14-2020