Laserfiche WebLink
DOH Form No. 788 <br />PIT IDENTIFICATION <br />McVey P't <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 HIGHWAYS <br />DIVISION OF HIGHWAYS <br />STATE OF COLORADO OWNER(S) <br />~~'~~ (Signature) <br />H,W,Harr~s <br />(Type Name <br />D°str~ct Eng°neer <br />(Title) <br />~r* ~ <br />(Mortgagee <br />By <br />Signature) <br />ype Name <br />ress <br />• *~~ <br />STATE OF COLORADO ) <br />ss. <br />County of },/-}G~9 ) <br />The foregoing instrument was acknowledged <br />before me this ~F, day of c~ cc,gy~• , <br />19 ~~ by .6[jr/e%6'/te~~.: /~'~ 2~, and <br />e ~ <br />Witness my hand and .official seal. <br />My commission expires , 19 <br />*.* <br />DISTRIBUTION: <br />ry Public <br />Original - Dist. Matls. Engr. (For Recording) <br />1 - Each Dwner <br />1 - District Engineer <br />1 - Design Engineer <br />- Dist. Const. Engr. <br />- Dist. Maint. Engr. (Maint. Pits) <br />1 - Each Holder of Mortgagee Deed <br />r; ~ (Signature) <br />N le McVe <br />(Type Name <br />BY~~ .' 24r . ~~l % .1=~~ <br />(Signature <br />Fern McVey <br />(Type Name <br /> <br />Page 3 of 3 <br />