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Agreement to Conduct Permitting by Electronic Means RECEIVED <br /> FEB 0 8 2016 <br /> Name of permittee representative desiring to OMSION OF RECLAMATION <br /> MINING AND SAFETY <br /> opt in to ePermit: L7 <br /> Title: i�1ZESi�C �`7�jV i3 ASS GI fF i�S, 11lw_, <br /> Name of permittee: LL <br /> Signature: <br /> ePermitting Administrator(if different from <br /> representative signing agreement) <br /> Email Address for ePermit Account: q•� 0-0b @ 60-,)b W)6 Cv Wk <br /> Notarized Affidavit of Signature <br /> STATE OF: 0, ) <br /> COUNTY OF: ( ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this c,%V day of 20 I(n by <br /> (date) )(month)" (year) <br /> as <br /> Q E,ely t UV .S -D AO g �' S t E is T, D t�v� A >SoC4jTFS, iNC-, <br /> (Name of permittee representative) (title) <br /> of <br /> k SOD P� LI�G <br /> Al a A A BRUNER (pe ittee) <br /> :6,; ,;PY PUBLIC <br /> 4 i . O): COLOR DO <br /> c xu i—I Ociorer 27.2018 GeJ <br /> NOTARY PUBL C <br /> (seal) <br /> My Commission expires: <br /> Page 3 of 6 <br /> CJ/t' <br />