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2015-07-20_PERMIT FILE - M2015028 (5)
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2015-07-20_PERMIT FILE - M2015028 (5)
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Last modified
8/24/2016 6:09:15 PM
Creation date
7/21/2015 8:36:35 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2015028
IBM Index Class Name
PERMIT FILE
Doc Date
7/20/2015
Doc Name
Application
From
Teton Drilling, Inc.
To
DRMS
Email Name
MAC
WHE
Media Type
D
Archive
No
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Limited Power Of Attorney <br />I, L tAQAlt v n residing at <br />S3 u --? " e- e+-- D, _ F -A- C.ol 1"'o 1 C 0 yo-s-zs— , hereby appoint <br />M i' K .t ?onn R � of 'Z'e+vv� I) 1-,i UA 0 _ n , as my Attorney -in -Fact <br />("Agent") to sign all required Colorado Division of Reclamation, Mining and Safety related forms for the <br />Limited Impact Operation (110(1)) Reclamation Permit. <br />This Power of Attorney shall become effective immediately and shall not be affected by my disability or <br />lack of mental competence, except as may be provided otherwise by an applicable state statute. This is a <br />Limited Power of Attorney. This Limited Power of Attorney shall continue until December 31, 2015. This <br />Limited Power of Attorney may be revoked by me at any time by providing written notice to my Agent. <br />Dated- (� , 20_y at <br />YOUR SIGNATURE: <br />YOUR PRINTED FULL LEGAL NAME: <br />6 N r.¢ 11,2 61-j',F <br />WITNESS' SIGNATURE: <br />WITNESS' PRINTED FULL LEGAL NAME: <br />WITNESS' SIGNATURE: <br />WITNESS' PRINTED FULL LEGAL NAME: <br />100U* 0f 'f-'Cvt oy <br />Subsed and sworn Mon <br />(Date) <br />(Notary Signature) <br />ADOLFO HERRERA JR. <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID 20144034594 <br />MY COMMISSION EXPIRES SEPTEMBER 04, 2018 <br />
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