Laserfiche WebLink
IDOH Form No. 790 <br />., . ;,~_ ___...~... ", . .. ._ .... BOOK /~53 PAGE .~~4/ <br />'"`" '' `" PIT'IDENTIFICATION <br />4lm. J. VanValkenburg <br />STA7E DEPARTMENT OF HIGHWAYS <br />DIVISION OF HIGHWAYS <br />STATE OF COLORADO <br />Robert G. Lucas <br />Materials Source Specialist <br />ajr* <br />ee <br />Signature <br />(Type Name) <br />(Address) <br />+*~ <br />STATE OF COLORADO ) <br />)ss. <br />County of ales ~ti ) <br />The foregoing instrument was acknowledged <br />before me th~•s ~ day of ~ u 4 , <br />19~', -by~=. o. "c~~.- C~ Lvca s , a d <br />Witness <br />My comrti <br />official seal. <br />OWNER(S) <br />xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx <br />BY °ac~u ~- x 1~z~" <br />Signat e) <br />Betty J~ _ ,"dy~,t~_---._._~-..._- __-- <br />lType Name) <br />By <br />(Signature) <br />ype Name <br />.~* <br />STATE OF COLORADO ) <br />' ) ss. <br />County of Jurhhan ) <br />The foregoing instrument was acknowledged <br />before me this 1$.th day of DQCPJnbPh , <br />19 $c} by B¢.ttcl J. GIUa~t and <br />~xxxxxxxxxxrvxxx and ~~~xxxxxxxxxx <br />Witness my hand and official seal. <br />19 My commission expires Novo-mbeli 5 .19 8$ - <br />"v y Commis5:or [xpiras March 25 ~ 193P, <br />vY C r nn i/ <br />~` t `S~ <br />Notary Public <br />DISTRIBUTION: <br />Original - Dist. Matls. Engr. (For Recording) <br />1 - Each Owner <br />1 - District Engineer <br />1 - Design Engineer <br />2 - Dist. Const. Engr. <br />1 - Dist. Maint. Engr. (Maint. Pits) <br />1 - Each Holder of Mortgage Deed <br />~~~~~~1~ <br />Notary Public <br />M.J. Uoadand <br />P.V. Bax 1 <br />cVa2den, CU 80480 <br />~`a „'„''''' <br />.o <br />". _ <br />\. <br />j <br />~ , -` ~ . <br />_ c, I,rri <br />' <br /> <br />- <br />` ~;, <br />- <br />., .~ '> <br />x; : <br />~~ . <br />~.. <br />'% ... <br /> <br />Pace 2 ..:' 2 <br />r.....r~ <br />