Laserfiche WebLink
BOOK ~S3 PAGE <br />DOH Form No. 790 <br />STATE DEPARTMENT OF HIGHWAYS <br />DIVISION OF HIGHWAYS <br />STATE OF COLORADO <br />... ..:. _. _.....__.t~, _ . . <br />- ::.:%icy::'.~:;.:~ItP;IT_,IDENTIFICATION <br />(Signature) <br />Robert G. Lucas <br />Type Name <br />J~1aterials Source Specialist <br />Title <br />~f-na <br />Wm. J. VanValkenburg <br />OWNER(S) <br />8y ~ <br />_ (Signature) <br />.-Richard <br />type 'ame <br />(Mortgagee <br />By By <br />(Signature) (Signature) <br />(Type Name) (Type Name) <br />(Address) <br />**# *:. . <br />STATE OF COLORADO ) STATE of co>:.oxrwo ;:~gP'::c.< :: <br />u <br /> <br />County of dJl es ~•. ) County of ~ c~ ; ~ ~:~ <br />~~ '' <br />The foi~gda`htj.'tFstrument was acknow]edged The foregoing instrun:eny 'wa~Y~3d-~owledged <br />befarP, toe'"£l;i's•.;'.ti day of Jghua~h , before me thi s ,,~,P' ,3a,;, a~~,;,: _, <br />19~a ' •b'~ <, <br />v- L~ c-s ,wand - 19~. by /~~ d,-d !~~=~~%~~~ _ ;_,:.; and <br />_{,..• ,, end <br />~r ~3 and % ~:i. •• • ~' ~ t~ ~ <br />Wi£i;r <br />~l~iitff.~~?tof~ cofficial seal. witness my ha ms anu ocficiai•~eai:• <br />v <br />My camY~sl3rt•>:c~pxu'es - , 19 My commission expires <br />of G0~" <br />,.~`/r1'y":,Commission Expir~~',tarch z5.' 98 ~ <br /> la~, <br /> Notary Public 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 />Page 2 of 2 <br />