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HomeMy WebLinkAboutC11-209 Land Use Agreement ECO Transit STATE OF COLORADO
MOTOR CARRIER SERVICES DIVISION ,�� t,. ---
Department of Revenue ixf.
N
1881 Pierce Street, Room 118
Lakewood, Colorado 80214 -1497
Phone (303) 205 -5691
FAX (303) 205 -5764 Bill Ritter, Jr
Governor
Roxanne Huber
Executive Director
Kirstie Nixon
Division Director
LAND USE AUTHORIZATION
The land used for the purposes of driver skill testing not owned by the CDL Testing Unit shall require
written permission from the respective landlord or land owner on this form and submit to the CDL
Compliance Section for approval prior to driver skill testing.
This certification confirms that (,is' /e Cateh
Landowner (print
is the property owner of the land located at:
321 Cooley /17P-.. •.tug (0'7
Property address
This property will be used for the purposes of CDL driver skill testing and access to the testing area
will be granted to the CDL Compliance Section for inspection at any time.
grants permission to
Lan caner (print) Landowner Representative (print)
e �0 aoisr / for the purposes of
CDL "Testing Unit name
administering the CDL driving skills test and State inspections.
I lk_ -"IC& I
Lando r Represent& siv,nature) Phone r? [)ate
l'his a tthoriration expires &tips 3'0 _ /�.
(Date, iFapplicable)