2016-01-19_GENERAL DOCUMENTS - M1983159

• Permit No: M1983159
• IBM Index Class Name: General Documents
• Doc Date: 1/19/2016
• Doc Name: Agreement to Conduct Permitting by Electronic Means
• From: S & S Aggregate, Inc.
• To: DRMS
• Email Name: DMC
• Email Name: SLB
• Media Type: D
• Archive: No

✓Agreement to Conduct Permitting by Electronic Means
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Name of permittee representative desiring to
opt in to ePermit:
Name of permittee:
Title:
Signature:
Email Address for ePermit Account:
STATE OF:
COUNTY OF:
�• ,
�,� RECEIVED
N 19 2016
DIVISION OF REcLAYATION
NININGA1D Y
5)1 3.6(
Anwok
Notarized Affidavit of Signature
) ss.
The foregoing instrument w s ac
before me this
owledged
(Name of permittee representative)
(seal)
My Commission expires:
/1 day of
(date)
as
of
02 O/by
(year)
(title)
—.My-Conintiesien Expires
January 9, 2017
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