Laserfiche WebLink
` Agreement to Conduct Permitting by Electronic Means ' I <br /> Name of permittee representative desiring to <br /> opt in to ePermit: f Odd CKe b ra-,i d <br /> Name of permittee: Leho-L4 <br /> C(/Y15 fi U Cfi�S , �nC <br /> Title: <br /> PreSl den4 <br /> Signature: <br /> Email Address for ePermit Account: -� f FFGt n Q061 a 4h a-L LU S tru LULL COM <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> CO to rctdo <br /> COUNTY OF: ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this day of JZJ /6 by <br /> (date) (year) <br /> Tood A Slpd(e.br"d asPres Ld e mf <br /> (Name of permittee representative) (title) <br /> of <br /> sj ho-14- Conti fru o�Ys I Tn,�- <br /> ��.., (permittee) <br /> TIFFANY HAWKINS <br /> NOTARY PUBLIC,STATE OF COLORADO <br /> wj <br /> My Comm. Expires 12115/2018 JWAP%�,Y �LIC <br /> (seal) <br /> My Commission expires: <br /> 12-l 151 <br /> Page 3 of 4 <br /> C <br />