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Agreement to Conduct Permitting by Electronic Means <br /> Name of permittee representative desiring to /� <br /> opt in to ePermit: Rariciy M C C lac r <br /> Name of permittee: R 0 C7rancie SLf ver � Lnc , <br /> Title: <br /> Con T u Ifa.r71 <br /> Signature: �� 1 h `-1 t iL i r1010 i2- -- <br /> Email Address for ePermit Account: r m(ii Ltt^ . h ecJc, f'1rt l Ain 9 $ CO w� <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> CO'oral° <br /> COUNTY OF: ) ss. <br /> v reArG./ <br /> The foregoing instrument was acknowledgedyy <br /> before me this day of/lardiu ZD/6 by <br /> (date) (year) <br /> Rctncly I`i'l�c (Ltrt as Ca►z L414-4111+ <br /> (Name of permittee representative) (title) <br /> of in Nla GrCaMe 31-IUPr - <br /> (permittee) <br /> CECILIA M. MCNEEL <br /> NOTARY C <br /> OF <br /> STATE OF COLORADO AVV( <br /> NOTARY ID 20154016485 <br /> MY COMMISSION EXPIRES APRIL 27,2019 NOTARY P LIC <br /> (seal) <br /> My Commission expires: <br /> - 1q <br /> Page 3 of 4 <br />