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2016-04-05_PERMIT FILE - M2015028
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2016-04-05_PERMIT FILE - M2015028
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Last modified
8/24/2016 6:20:34 PM
Creation date
4/12/2016 9:33:02 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2015028
IBM Index Class Name
PERMIT FILE
Doc Date
4/5/2016
Doc Name
Adequace Response No. 3
From
Teton Drilling, Inc.
To
DRMS
Email Name
MAC
Media Type
D
Archive
No
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Limited Power Of Attorney <br />I, /M qL,L &l4} , residing at <br />5.3 0 7 wkt1 *.— D. . A.A- 4.11m) 1 CO 'os'zr-- , hereby appoint <br />01 i4 Ton i of Te+o✓i brit' . pn , as my Attorney -in -Fact <br />("Agent") to sign all required Colorado Division of Reclamation, Minmg'and Safety related forms for the <br />Limited Impact Operation (110(1)) Reclamation Permit. <br />This Power of Attorney shall become effective immediately and shall not be affected by my disability or <br />lack of mental competence, except as may be provided otherwise by an applicable state statute. This is a <br />Limited Power of Attorney. This Limited Power of Attorney shall continue until December 31, 2015. This <br />Limited Power of Attorney may be revoked by me at any time by providing written notice to my Agent. <br />Dated )011 t Co , 20 ( ,Sat <br />YOUR SIGNATURE: <br />YOUR PRINTED FULL LEGAL NAME: <br />saw of_i Glo Ou of <br />and swam me on . 0 • <br />WITNESS' SIGNATURE: <br />WITNESS' PRINTED FULL LEGAL NAME: <br />WITNESS' SIGNATURE: <br />WITNESS' PRINTED FULL LEGAL NAME: <br />Nal SPattai) <br />ADOtFO HERRERA JR. <br />NOTARY MESTATE OF COLORADO <br />NOTARY ID 20144034594 <br />MY COMMA EXPIRES SEPTEMBER 04, 2018 <br />
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