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Motorcross Pit Consent Agreement <br /> Page 3 of 3 <br /> March 14,2023 <br /> Operator's Notarized Signature: <br /> As an authorized representative of the Operator, I hereby attest the Operator concedes to the <br /> above described violation and agrees to comply with the Corrective Action and Civil Penalty <br /> proposed in this STAFF SUMMARY FORM FOR CONSENT AGENDA ITEMS. <br /> Signed and dated this �J� day of�1!31gat:4 , 2023. <br /> (Operator) <br /> Signature: <br /> Title: ��'. Vi [L Ff245—;5 i4Ae'-JT <br /> State of C—,r'C01peN O <br /> County of <br /> The foregoing instrument was acknowledged before me this I J day of Mr.,rCh <br /> by MC 7.A(, Z-% Mffl�Cffl" as k)A-o-(LA Tdol1C, of 5E-"A Cc>tj�(-o4 ►'���C=. <br /> MCKENZIE ZIM ERM N Notary ubliC <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY iD -0174042457 <br /> MY COMMISSION EXPIRES OCTOBER 31,2026 My Commission Expires: Qc� obey �J 1,2©2G <br /> SIGNATURES MUST BE IN BLUE INK <br />