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DOH Form No. 788 <br />(Type Name <br />' The owner hereby warrants that he has good title to the above described premises, that he <br />has the lawful right to grant this Option, and that he agrees to hold the Department <br />harmless from any and all claims from others asserting any interest in the subject land. <br />STATE DEPARTMENT OF hiIGH41AY5 <br />DIVISION OF HIGHWAYS <br />STATE OF COLORADO <br />(Signature) <br />James E. Sutherland <br />(Type Name) <br />Assistant Dist. l4aterials Engineer <br />(Title) <br />Colorado Divis *o * of Highways <br />Mortgagee <br />By <br />Signature <br />My commission expires <br />1 <br />Addre~~) <br />*~* <br />STATE OF COLORADO ) <br />ss. <br />County of ) <br />The foregoing instrument was acknowledged <br />before me this day of , <br />19 _, by , and <br />and <br />Witness my hand and official seal. <br />19 <br />Notary Public <br />*rr <br />DISTRIBUTION: <br />Original- Dist. Matls. Engr. (For Recording) <br />1 - Each Owner <br />PIT IDENTIFICATION <br />~~ulty Pit <br />OWNER(S) <br />~, ~~)•.. <br />(Sigr~tatdre) ( ' <br />~ ohn A. McNulty <br />(Type Name <br />By <br />Signature <br />(Type Name <br />1 - District Engineer ~~_ao-» <br />1 - Design Engineer ,i - <br />~~~~~ ~ ~vY <br />Z - Dist. Const. Engr. ~~ <br />1 - Dist. Maint. Engr. (Maint. Pits) <br />Mr/n~ r_~q^' Z C..y i~~ <br />1 - Each Holder of Mortgagee Deed <br /> ir-a•-7• <br />~.do~ <br />Page 3 of 3 <br />