Laserfiche WebLink
Agreement to Conduct Permitting by Electronic Means <br /> Name of permittee representative desiring to <br /> opt in to ePermit: M i,{ I L. (�--'note v-- <br /> Title: <br /> 0171(p. 1Ji rmi-r . ntCt I -1)i ref er - <br /> Name of permittee: ) (-5-rai�,ic � <br /> P (-) I vex, Svc.„ <br /> Signature: <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 /> "Iola ha <br /> COUNTY OF: ) ss. <br /> Inc -)a 1 <br /> The foregoing instrument was acknowledged <br /> before me this a-4-t' day of /p tri I , ,)-0ICQ by <br /> (date) ( onth) (year) <br /> as <br /> ?a u I L . G k QotCoq). brI v i✓v n r nta i i r('_C_- <br /> (Name of permittee representative) (title) <br /> iu Ci tr�ett- 3 Iv � 717-6 C C . <br /> d A. A �"p® ®' "' (permittee) <br /> ANN C. ROBISON . <br /> P Notary Public l <br /> 4 State of Idaho (_) -KLA C 6 C)-u %l,-/ <br /> NOTARY PUBLIC <br /> (seal) <br /> My Commission expires: <br /> i013l [Doi ie <br /> Page 3 of 6 <br />