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117 <br /> 5. Executed on the date first written above. <br /> GRANTOR: Crystal Lakes Water and Sewer <br /> Association, a Colorado nonprofit corporation <br /> (SEAL) <br /> B 111111bAbli <br /> By �.J. -""'r`"na <br /> Name G DOUGLAS-s f C:6c <br /> Title P t i1 UV Alec. <br /> Date ( 7. U/‘ <br /> Af, <br /> By ((%, /:- i/7 <br /> Signature <br /> Name j/ // /-7 <br /> Title <br /> Date y: <br /> NOTARY REQUIRED <br /> State of Colorado ) <br /> County of La �� / SS. <br /> The foregoing instrument was acknowledged before me on 0-41.wiAL L , 2016, by <br /> Lt (Name)as Pr16i d ',lel, (Title) and <br /> 4(1C l'( (Y C I I (Name)as i, t n i-� itie)of the Crystal Lakes Water and <br /> Sewer Association, GWEN A. COOK <br /> tj NOTARY PUBLIC <br /> STATE OF COLORADO <br /> Witness m hd and cial l. j NOTARY ID a><20054022435 <br /> yanoffiseaM, NOTARY <br /> EXPIRES AUGUST 21,2017 <br /> r. , <br /> 0,L Notary Public <br /> My commission expires I Zi /2 C 17 <br /> (Colorado Water Conservation Board will record Amendment to Deed of Trust with the County.) <br /> Attachment C <br /> Page 2 of 2 <br />