My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2016-05-23_GENERAL DOCUMENTS - M2000073
DRMS
>
Day Forward
>
General Documents
>
Minerals
>
M2000073
>
2016-05-23_GENERAL DOCUMENTS - M2000073
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/24/2016 6:22:25 PM
Creation date
5/24/2016 9:17:55 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2000073
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
5/23/2016
Doc Name
Agreement to Conduct Permitting by Electronic Means
From
XTO Energy Inc. - Kelly Kardos
To
DRMS
Email Name
THM
SLB
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
3
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
• Agreement to Conduct Permitting by Electronic Means <br /> A <br /> Name of permittee representative desiring to _ <br /> opt in to ePermit: X \ Q L\Q. C�\ <br /> Name of permittee: <br /> \13 �o�cdGC� <br /> Title: ( Sc <br /> YZIYYI 1� vil 5\t‘ Q.0 V \SC`r'C <br /> Signature: <br /> Email Address for ePermit Account: <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> 612e-0R/460 <br /> ?/1f D <br /> COUNTY OF: ) ss. <br /> i» /4S <br /> The foregoing instrument was acknowledged <br /> before me this j/ day of/f'j 2.0 by <br /> (date) (year) <br /> as <br /> (Name of permittee representative) (title) <br /> of <br /> fkyp6, <br /> ��' Q;• •;�,,, (permittee) <br /> 2' r'AULINE <br /> HERBERT. aI • <br /> Nle•'•. 0 <br /> 00=9� ` ,..__... �`�°���� NOTARY PUBLIC , <br /> FXPIRO <br /> (seal) <br /> My Commission expires: <br /> Jv2(J �, 26/6 <br /> Page 3 of 4 <br />
The URL can be used to link to this page
Your browser does not support the video tag.