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2016-06-02_GENERAL DOCUMENTS - M2005061
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2016-06-02_GENERAL DOCUMENTS - M2005061
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Last modified
8/24/2016 6:22:58 PM
Creation date
6/28/2016 3:59:57 PM
Metadata
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Template:
DRMS Permit Index
Permit No
M2005061
IBM Index Class Name
General Documents
Doc Date
6/2/2016
Doc Name
Agreement to Conduct Permitting by Electronic Means
From
DRMS
To
M.A. Concrete Construction, Inc.
Media Type
D
Archive
No
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5. Affiant will inform the Division of Reclamation Mining and Safety within thirty <br />(30) days in the event that his/her authorization to execute ePermitting Documents <br />on the Company's behalf is terminated. <br />Further, Affiant sayeth not. <br />Affiant's name <br />.) G� A <br />Signature <br />Notarized Affidavit of Signature_ <br />STATE OF: <br />COUNTY OF: ) ss. <br />The foregoing instrument was acknowledged <br />before me this 3rd day of by <br />(date) onth) (year) <br />i as <br />(Nahle of permittee re esentative (title) <br />of <br />(permittee) <br />COLLEEN HELEN VAUGHN <br />NOTARY PUBLIC <br />STATE :OF COLORADO <br />NOTARY ID #20144025273 NOTARY PUBLIC <br />My Commission Expires June 26, 2018 <br />(seal) <br />My Commission expires: <br />
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