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r <br />The Owaar hereby warrants that ha has good title to the above described pre- <br />mises; that ba bps the iavful right to grant this Optioa~ and that ha agrees to <br />hold the Departsmnt harmless fro. any and all alaius from othe;a asa~rtiag aRy <br />interest io the subjeee Land. <br />Additional Conditions t~~ r3~N to s,~11 M oUrr ~tio~ <br />• <br />DBPARTMBIi! OF HIGHiIAYS, STATE OP COI.QAADO - - <br />Amer T~ Insert as appeer s <br />above)) <br />Bv: L7~~~C'-~ Asst. ~::c2. S~~rt. Bv: <br />BY: By: <br />ALP:el <br />DISTRIBUTION: <br />Original - Design Bngineer <br />i - Owner or each Owner <br />1 - Materials Engineer - Denver <br />2 - Construction Engineer - District <br />1 - Meintenaace Engineer for all State Forces Projects <br />i tit * f t t t*# <br />• <br />STATE OF ) <br />SS <br />COUNTY OF ~ ) <br />The foregoing instrument was acimowledgsd before me Lhis day of <br />, A. D. 19 , by <br />Nitnesa my hand and official asal. <br />My eomaisaion expires <br />(SEAL) <br />Notary Public <br />(Original to be aelmowladgad and recorded if, in the opinion of the District <br />Engineer, there is possibility of traaafez of the premises or question of title, <br />Refez to D.O.H. Memo Mo. 418, dated April 7, 1972.) <br />Please attach plat of pit area. <br />Field Sample No. <br /> <br />';~ <br />Pass 2 <br /> <br />