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� COLORADO <br /> � Department of Transportation <br /> ' Region 3 <br /> R3 Traffic Section, Access Unit <br /> 222 S 6�h St, Rm 100 <br /> Grand Junction, CO 81501 <br /> PH (970)683-6284 FAX(970)683-6290 <br /> ««< e-mailed »»> <br /> December 17, 2021 Permit No. 321125 <br /> Gary Knippa <br /> 33084 Bergen Mountain Rd. <br /> Evergreen, Colorado 80439 <br /> Dear Permittee: <br /> 1. Please review the attached State Highway Access Permit (Form#101)and all enclosed attachments <br /> 2. if you ACCEPT the Permit and its Terms and Conditions (and are authorized to sign as tegal owner of <br /> the property, or as an authorized representative), please comptete the DocuSign process within 60 <br /> days of the transmittal date on the permit. Your signature confirms your agreement to alt the listed <br /> Terms and Conditions. <br /> 3. If you fail to complete the DocuSign within 60 days, the Colorado Department of Transportation <br /> (CDOT) will consider this permit withdrawn. <br /> 4. You may use the PayPal link to pay for this permit or send a check or money order made payable to <br /> "CDOT"for the total amount due of$100.00 to our office. <br /> 5. If you wish to APPEAL the Terms and Conditions of the permit, please refer to the attached Form <br /> 101, Pages 2 and 3 for an explanation of the appeal procedures. <br /> 6. As described in the additional attached Terms and Conditions, you must make a written request to <br /> obtain a Notice to Proceed. DO NOT begin any work within the State Highway Right-of-Way without <br /> a validated Access Permit and Notice to Proceed. Use of this permit without the Colorado Department <br /> of Transportation's validation shall be considered a violation of State Law. <br /> If you have any questions please call Kandis Aggen, Asst. Access Manager, at (970) 683-6270 or Brian <br /> Killian, Region 3 Access Program Manager, at (970) 683-6284. <br /> If you choose to return the signed permit and/or check by mail, please send to: <br /> Region 3 Access Unit <br /> Attn: Kandis Aggen, Asst. Access Manager <br /> 222 S 6�'St, Rm 100 <br /> Grand Junction, CO 81501 <br /> R3 Traffic Section, Access Unit, 222 5. 62h Street, Rm 100, Grand Junction, CO 81501 PH(970)683-6284 www.codot.gov <br />