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NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEGED Y: <br /> Structure Owner C _Name <br /> Date _ T ���� Title <br /> STATE OF t .r !��) <br /> ss. <br /> COUNTY OF <br /> Thg foregoing was ack owledged before me this day of ���,20_, �y <br /> as of <br /> _ My Commission Expires: <br /> N <br /> a Public <br /> �rw <br /> MOUW� <br /> STAT[OF COLORADO <br /> NOTARY f0 200340161`59 <br /> Y GOAo�tBSj0N EtPIRES JUf&2 202 <br />