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Agreement to Conduct Permitting by Electronic Means <br /> Name of permittee representative desiring ton <br /> opt in to ePermit: Rorsdy 11 L C I tkr . <br /> Name of permittee: R U (7 rar de SLI ve r i Ley <br /> Title: C O Y)S uJ+Ct Yc <br /> Signature: �Jri 21 *awe <br /> ---fi _Email Address for ePermit Account: /I / �►�10 <br /> rnufiLtre heck- Ain() , Cove. <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> Co l orc Ao <br /> COUNTY OF: ++ ) ss. <br /> The foregoing instrument was acknowledgedyy <br /> before me this day of/ ar - 2-0/6 by <br /> (date) (year) <br /> Rc tn ply n'1(C(k fc as Co►e15- u(441 <br /> (Name of permittee representative) (title) <br /> of <br /> R Crc e 5c.luer rm. . <br /> (permittee) <br /> CECILIA M. MCNEEL <br /> NOTARY PUBLIC <br /> STATE OF COLORADOo4dijti, Lai( <br /> NOTARY ID 20154016485 <br /> MY COMMISSION EXPIRES APRIL 27,2019 NOTARY PUALIC <br /> (seal) <br /> My Commission expires: <br /> r)`-/- O7 - i cf <br /> Page 3 of 4 <br />