HomeMy WebLinkAbout1418 W OAK ST - AFFIDAVITS - 1/24/2020City of
art Collins
AFFIDAVIT
RECEPTION #20200006129, 1/28/2020 12:05:49 PM,
1 of 1, $13.00
Angela Myers, Clerk & Recorder, Larimer County, CO
(as required. by Section 4.7(D)(3), Section 4.8(D)(3)
or Section 4.9(D)(3) of the Fort Collins Land Use Code)
I/we, �CRJWJ�C� 440 "V) , as owner(s) of record of the property located
at: r0a_ , , Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies)
IV I am/ we are acting on my/ our behalf for the purpose of obtaining a building permit for a new,
detached accessory building to be constructed at the above -listed property. The building will be
constructed with water and/or sewer service. By signing this affidavit, I/we declare that the building
will not be used as a dwelling unit.
❑ 1 am/ we are acting on my/ our behalf for the purpose of obtaining a building permit for an alteration
to an existing, detached accessory building located at the above -listed property. The alteration
includes adding water and/or sewer service to the existing building. By signing this affidavit, I/we
declare that the building will not be used as a dwelling unit.
I/we understand that using the building as a dwelling unit without approval from the City of Fort Collins will
be a violation of the Fort Collins Land Use Code and could result in a court summons.
Sign in the presence of Notary Public, record- document with the Larimer County Clerk and Recorder, and submit a copy of the
recorded docu nt with t e buil ing pe .mit for the work checked above.
J '
Owner / Co-owner
The foregoing Affidavit was acknowledged before me on this e% 1 k day of
A r)COO (month, year) by ,;1Do7�9 JorQt� ��U j %t f� .
Witness my hand and official seal
My commission expires: I,)-( I _D3