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,. <br />The Owner hereby warrants that he has good title to the above described pre- <br />wises; that he has the lawful right to grant this Option, and that he agrees to <br />hold the Department harmless from any and all claims from others asserting any <br />interest in the subject land. <br />Additional Conditions :~±. ~~ >A~~a_:,~ ~~~ y -933F1 -f~^ <br />u <br />~`l.~ QA T M~ 11Td ^A~ f SQy .~~+ <br />DEPARTMENT OF HIGHWAYS, STATE OF COLORADO ~~/ ~; ,,:- ~ '~~,~.~~~= <br />(Own. (s) - Insert as appears <br />above)) <br />Dlatrict ~+.ataTiPi7 Ek~inxas <br />By: By: <br />ALP:el <br />• llISTRIBUTION: <br />Original - Design Engineer <br />1 - Owner or each Owner <br />1 - Materials Engineer - Denver <br />2 - Construction Engineer - District <br />1 - Maintenance Engineer for all State Forces Projects <br />J <br />*,~*~**>tit*** <br />STATE OF <br />SS <br />COUNTY OF <br />The foregoing instrument was acknowledged before me this day of <br />A.D. 19 , by <br />Witness my hand and official seal. <br />• My commission expire <br />(SEAL) <br />Notary Public <br />(Original to be acknowledged and recorded if, in the opinion of the District <br />Engineer, there is possibility of transfer of the premises or question of title. <br />• Refer to D. O. H, Memo No. 418, dated April 7, 1972.) <br />Please attach plat of pit area. <br />Field Sample No. <br />Page 2 <br />