Laserfiche WebLink
Agreement to Conduct Permitting by Electronic Means <br /> 5. Affiant will inform the Division of Reclamation Mining and Safety within thirty <br /> (30) days in the event that his/her authorization to execute ePermitting Documents <br /> on the Company's behalf is terminated. <br /> Further, Affiant sayeth not. <br /> K\(LK -p Ne N L- N C� <br /> Affiant's name <br /> ignature <br /> Notarized Affidavit of Sign_ature <br /> STATE OF: <br /> COUNTY OF: �'i� - c v ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this 1�)4 day of �3—a by <br /> (date) (month) (year) <br /> as <br /> Vuo N'f MA N RGE-'(, <br /> (Name of permittee representative) (title) <br /> of <br /> (permittee) <br /> NOTA PUBLIC <br /> JAMIE LYNN RECK <br /> (seal) NOTARY PUBLIC <br /> STATE OF COLORADO <br /> My Commission expires: NOTARY ID 20134057481 <br /> XX/ MY COLIMISSION EXPIRES 09109/2017 <br /> Page 5 of 6 <br />