HomeMy WebLinkAboutSub Permit.440 N 5th St.0072.2019 (8).ARBK P •
PERMIT NUMBER: ADDRESS: 440 NORTH 5TH STREET
COMMUNITY DEVELOPMENT DEPARTMENT
HOMEOWNER ASSOCIATION COMPLIANCE FORM Tim CITY orA
All applications for a building permit within the City of Aspen are required to include a certification of compliance
with applicable covenants and homeowner association policies. The certification must be signed by the property
owner or Authorized Agent representing the property owner. The following certification shall accompany the
application for a permit.
ADDRESS 440 NORTH 5TLH ST. UNIT# PARCEL ID# 273512497001
I,the property owner, certify as follows: (pick one)
This property is not subject to a homeowner's association or other form of private covenant.
❑ This property is subject to a homeowners association or private covenant and the improvements
proposed in this building permit do not require approval by the homeowners association or covenant
beneficiary.
❑ This property is subject to a homeowners association or private covenant and the improvements
proposed in this building permit have been approved by the homeowners association or covenant beneficiary.
I
understand the City of Aspen does not interpret, enforce, or manage the applicability, meaning or effect of
private covenants or homeowner association rules or bylaws. I understand that this document is a public
document.
Owner Signature Date
Owner Printed Name
OR
Authorized Agent Signature /�'.� Date 2-25 1 9
Authorized Agent Printed Name RICHARD
PALARDY
RE(,.0 F IV
CITY OF ASPENAugust2017 130 S. GALENA ST ASPEN, Ciiij
• BUILDING DEPARTMENT