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HomeMy WebLinkAboutC14-215 Land Use Authorization STATE OF COLORADO
MOTOR CARRIER SERVICES DIVISION
Department of Revenue i ig 16
1881 Pierce Street, Room 118 .. ;:::: ,'
Lakewood, Colorado 80214-1497 ' Of
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 Eagle County
Landowner(print)
is the property owner of the land located at:
32RP CnolPy Mesa Rd Gypsum CO 81637
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.
Fagla County Jill Ryan grants permission to
Landowner(print) Landowner Representative(print)
ECO Transit for the purposes of
CDL Testing Unit name
administer' g h CDL d• vin s lls test and State inspections.
At/ 970-328-8605
Lando er Representative(si_ ature) Phone# Dat
This authorization expires on 7/1/2015 •
(Date,if applicable)
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