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Operator(s) Signature: <br />By signing this, the Operator agrees with the request to extend the review period beyond the 365 <br />days to January 8, 2014, as outlined above on the Staff Summary Form for Consent Agenda <br />Items. <br />Operator Signature Date <br />STATE OF <br />COUNTY OF } <br />The forgoing instrument was hereby acknowledged before me this day of , <br />by , who is personally known to me or has provided <br />as identification, and who signed this instrument willingly. <br />Notary Public <br />My commission expires: <br />