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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 /> Affiant's name <br /> 4 .4c, <br /> ,� <br /> Signature, <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> �iLCJO <br /> COUNTY OF: 4-4,-I�W5 X---, ) ss. <br /> The foregoing instrw&nffas acknowledged <br /> before me this 44 day of by <br /> (date) (month) (year) <br /> as <br /> (Name of p rmittee r presentative) (title) <br /> of <br /> _ (perm tee) <br /> CAROL WRIGHT <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID#20094040322 <br /> MY COMMISSION EXPIRES DECEMBER 09,2017 <br /> NOTARY PU LIC <br /> (seal) <br /> My Commission expires: <br /> Page 5 of 6 <br />