2016-04-19_GENERAL DOCUMENTS - M1983037

• Permit No: M1983037
• IBM Index Class Name: General Documents
• Doc Date: 4/19/2016
• Doc Name: Agreement to Conduct Permitting by Electronic Means
• From: David Wyman
• To: DRMS
• Email Name: SLB
• Media Type: D
• Archive: No

Agreement to Conduct Permitting by Electronic deans
Name of permittee representative desiring to
opt in to ePermit: 0.VT► U �^
Name of permittee:
V 1M.o►.v�
Title: Ma van c, PV-
Signature:
Email Address for ePermit Account: bre k,eyo.6ox i-All l Ck, p/a�t00• C O �-
Notarized Affidavit of Signature
STATE OF: /� )
COUNTY OF: ) ss.
D U a,t--
The foregoing instrument was acknowledged (�
before me this 1 day of �1�' ,�o by
(date) (year)
as
0 ft-
(Name of permittee representative) (title)
of
ADRIANA ROBBINS (permit ee)
Notary Public
State of Colorado
Notary ID 20094036938
My Commission Expires Nov 20, 2017
NOTARY PUBLIC
(seal)
My Commission expires:
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