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Eu-IB.I,c A <br /> E ���=IvED • Graver <br /> zc"Ilgli 8 DEC Z 1 1978 Check One water <br /> C] <br /> EXHiBrT Soil� Other <br /> 6cH/BlT F RECLAMMIGN SECTION _ <br /> FjcHiBiT(� Co'.o. 46F@I Agg p6;fiff NUMBER_ <br /> El Paso County <br /> DEPARTMENT OF PUBLIC WORKS <br /> �3311700 Century, Colo. Spgs. , Colo. 80907 <br /> Seller /% ��f O / " "` Dated 19 ,� <br /> Address 6'�C C// Refer to the above number or <br /> with provide copy of this order <br /> .�' with an claim you may find <br /> necessary to file. <br /> I declare that I am owner of the real roo_ erty wherein !CZ <br /> exists and is located in Township 2F (s) , Range- <br /> Section O Quarter S GC The Deoartment of <br /> Public Works may purchase from me, in the Quantity <br /> estimated below, during the period - - to include <br /> subject to the following e 1 rovis ' n . <br /> (If n e his will a so noted hereo /r <br /> � 1 <br /> Unit of Approx. No. Cost <br /> Measure of Units Per Unit <br /> Payments to be made monthly by Warrants issued by El Paso County based upon <br /> the number of units purchased during prior month. <br /> AAM/ <br /> (Signature Seller) <br /> Purchase Order Acauired by C <br /> Signature <br /> Tit <br /> t 61,e,4�7-a-0-3,t::2 <br /> (Purchasing Agent <br /> By 7 <br /> Purchase Order Approved by `2,, , <br /> Max L. Roths6hild, P.E. <br /> Director of Public Works/County Engineer <br />