2016-05-04_GENERAL DOCUMENTS - M1977215

• Permit No: M1977215
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 5/4/2016
• Doc Name: Agreement to Conduct Permitting by Electronic Means
• From: Rio Grande Silver, Inc.
• To: DRMS
• Email Name: THM
• Email Name: SLB
• Media Type: D
• Archive: No

Agreement to Conduct Permitting by Electronic Means
5. Affiant will inform the Division of Reclamation Mining and Safety within thirty
(30) days in the event that his/her authorization to execute ePermitting Documents
on the Company's behalf is terminated.
Further,Affiant sayeth not.
Pa e_t l L . C71 arle
Affiant's name
14
Signature
Notarized Affidavit of Signature
STATE OF: )
la 11C)
COUNTY OF: • ) ss.
The foregoing instrument was acknowledged
before me this -4± day of �-- olO 1 jp by
(date) (month) (year)
as
?Qui► L • C1-711 . C�h v tro ,r -r) I c,c.L '
(Name of permittee representative) (title)
of
R 1.0 C-71(a-rVLe � Ji 1► e},e,
(permittee)
ANN C. ROBISON
Notary Public
State of iaan� J 0-- • e7bc-�=ZC-=l�
NOTARY PUBLIC
(seal)
My Commission expires:
I 0/ /DO) 3/
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