HomeMy WebLinkAbout430 N COLLEGE AVE - AFFIDAVITS - 5/28/2019Fort 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) ' 6o�> as owner of record (property
address) LbLLFue A%,j+e known as (name of
business) AZS i�iS 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.
X I am giving permission for interior work only. The scope of the work shall be
limited to: jk'.XC AQ1L
❑ 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 name, please print)
The foregoing affidavit was acknowledged before me on the day of
aC) H (month, year)
for the purpose thereW set forth.
Witness my hand and official seal.
My Commission expires: 06 aCi I au
Permit #
Office use only
Notary Public
MARY RICHLING
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19914001245
MY COMMISSION EXPIRES OCTOBER 29. 2022