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HomeMy WebLinkAboutC11-210 Land Use Agreement Eagle County School District STATE OF COLORADO
MOTOR CARRIER SERVICES DIVISION .
Department of Revenue
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 testinp, 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 ______14idli_CoCeh4
7 Landowner (print4
is the property owner of the land located at:
32Y Q /ev 7r ?d Co F/4 2 .
Property address
This property will be used for the purposes of CDL driver skill testing and access to the testing area
will he granted to the CDL Compliance Section for inspection at anytime.
eal,(e. 1:0; grants permission to
Landowner (print) • Landowner Representative (print)
C joco/ 4.)-.Ct// for the purposes of
CDL Testing Unit name
Lt the CDL driving skills test and State inspections.
0 11 - 0. ;3 (0. DR-1
ind Represei - Phone ' Date
this authoritation expires on V .2„9/
(Date. applicable)