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<br />9-25-2000 9=59AM FROM~Ui EARTH MOVERS INC 779 852 2~
<br />COLORADp DEPARTMENT OF TRANSPORTATION Issmn~auUwAy anphcmlo,r
<br />(STi4TE HIGHWAY ACCESS PERMIT APPLICATION "`"`''""""`""
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<br />Instructions: - contact the DCparU:Tent of Transportation or your local cltrvorn mCnl ip determine your issuing authority.
<br />- contact the issuing authority to determine what plan:: and other documents ale required to br. subrnitled
<br />wdh your application.
<br />- complete this form (snn1J 9ucstio ns may not apply to you) and attach all necessary Uocw ncnt5 vud
<br />SUhn111 4 to IhC ISiuInJ auihc')ily, $VUln i; an JPpIiCRtIUn (Gr Cach aC CCSS rCGuL SI C21.
<br />- if you h<lVC any yuestlonc contact the isC Uiny autho ritY. !?laase print o! type
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<br />J) SuLlrl. cj. n, An'an,(. Ur tWeibpmunt ylan Il i'rOpl o{ba Ldr:r in SUL~nCY.
<br />II an access perrnd is issued to you d wdf state [hc Icrln;; and co ndillo rs lo( its lyre. Any changes in the use of IhC Pe«nitted
<br />.-)cress riot cosis:cc,; '+: iL': ta:: 'crmc ,r-rtl cel:U iUn nr. Ir<ICU on the Pct ma tnay be ccnsidurcU n violation of the permit.
<br />The applicant declares under penalty o! perjury iD the secono da greC, anq any other aPPiicable state or lederal
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<br />knOwletlge IfUB
<br />I:)wS, that all 7n /o nnalion provitled on Uu5 tOrm and SuUl nillCd altaC hnlenlS are to the pCSI of thoh
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<br />II 7hr. ;ipfifiGanl I$ riot iho owner OI iho Pro(i.: rig, wu rcquin~ t:Ti:: app hc2bun also In be signeU by lh(: property owner or their
<br />Ier]ally authori[cU n'pres CntaUve (cr other acCCptable vJ(IIfAn c•~ane ncej This signature Shall Constitute agreement wile this
<br />application by all owner:; of ~interest unlcs;. , utcU in writing II a p^r[nh r: authorized. the property owner will Ue listetl a5
<br />Ulc permlllcu.
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