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Agreement to Conduct Permitting by Electronic Means <br />Name of permittee representative desiring to <br />opt in to ePermit: <br />Title: <br />Name of permittee: <br />Signature: <br />ePermitting Administrator (if different from <br />representative signing agreement) <br />Email Address for ePermit Account: <br />STATE OF: <br />Colorado <br />Matt R. Carnahan <br />RECD: IED <br />FEB : , 12016 <br />DIVISION L. CLAMATION <br />MINING Attu SAFETY <br />Resource & Environmental Manager <br />Oldcastle SW Group, Inc. dba Four Corners Materials <br />n 1 <br />Peter Siegmund <br />Matt.Carnahan@oldcastle-materials.com <br />Notarized Affidavit of Signature <br />COUNTY OF: ) ss. <br />La Plata <br />The foregoing instrument was acknowledged <br />before me this 21 day of January , 2016 by <br />Matt R. Carnahan <br />(Name of permittee representative) <br />KRISTIN MARGUERITE ROEHRS <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID 20134046325 <br />MY COMMISSION EXPIRES 07/2512017 <br />(seal) <br />My Commission expires: <br />(date) (month) (year) <br />as <br />Resource & Environmental Manager <br />(title) <br />of Oldcastle SW Group, Inc. <br />dba Four Corners Materials <br />(Oil -6/2017 <br />(permittee) <br />Page 3 of 6 <br />NOTARY PUBLIC <br />