Laserfiche WebLink
Agreement to Conduct Permitting by Electronic Means <br /> Name of permittee representative desiring to <br /> opt in to ePermit: R;I u I L. (4-Ind e v <br /> Title: ('oyp. E,1vi r0111"YY, r)IU I Tl refj- <br /> Name of permittee: <br /> l i /te, 1 ( Vti✓) Svc . <br /> Signature: <br /> 410411/ <br /> ePermitting Administrator(if different from <br /> representative signing agreement) Randy McClure <br /> Email Address for ePermit Account: rmcclure@hecla-mining.com <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> :Idaho <br /> COUNTY OF: ) ss. <br /> 1A r-la I <br /> The foregoing instrument was acknowledged <br /> before me this _--q-_' day ofto y-i I , jO1(� by <br /> (date) ( onth) (year) <br /> as <br /> ?c U I L , Cr"lCple--4 (i✓x(p- brl lit✓Un rr r tai i rPT__ <br /> (Name of permittee representative) (title) <br /> of -; • <br /> H) o e-rarat. c-) I W{) Tr)C . <br /> *s_....a 4,. A o .o . A A f (permittee) <br /> 4 ANN C. ROBISON <br /> • Notary Public 0f��iJ 0 2 )b <br /> CK __)1� <br /> I State of Idaho ; <br /> NOTARY PUBLIC <br /> (seal) <br /> My Commission expires: <br /> i 00' iDoi S' <br /> Page 3 of 6 <br />