Laserfiche WebLink
Agreement to Conduct Permitting by Electronic Means <br /> Name of permittee representative desiring to n <br /> opt in to ePermit: L.i� 1 L. (%100i e <br /> Title: 01)1(p. El1vi y''oY)i-r ,. flt t ( 1)i r <br /> Name of permittee: <br /> i • Li ► (VE✓) Sir - <br /> Signature:g air <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 /> L(1o. ho <br /> COUNTY OF: ) ss. <br /> hUi-la 1 <br /> The foregoing instrument was acknowledged <br /> before me this al•t' day of v I , Gl.UI(P by <br /> (date) ( onth) (year) <br /> as <br /> ?a u. 1 L . Ci 1 Cid e-r (LXp. Com.'l v i►/o n n-Y.Oct( -b1 rr.r: <br /> (Name of permittee representative) (title) <br /> .. .�v of iib &rar�t� -) ► (ver) 1v)C . <br /> •.dam. i�� Al. _ 0♦ <br /> 4 (permittee) <br /> ANN C. ROBISON 9 <br /> Notary Public <br /> 0 � � <br /> ® State of Idaho !2� 0 t Z <br /> NOTARY PUBLIC <br /> (seal) <br /> My Commission expires: <br /> lOOl /DOI Si <br /> Page 3 of 6 <br />