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Agreement to Conduct Permitting by,Electronic Means <br /> Name of permittee representative desiring to <br /> opt in to ePermit: "('�t�w <br /> Title: <br /> AN0r=0, <br /> Name of permittee: L A2Y LAry#� LL P <br /> -SN-? <br /> Signature: <br /> ePermitting Administrator(if different from <br /> representative signing agreement) — <br /> r <br /> Email Address for ePermit Account: <br /> s <br /> Notarized Affidavit of Signature <br /> STATE OR ) <br /> �olC>rado <br /> COUNTY OF: ) ss. <br /> The foregoing instrument was acknowledged before me this 15 day of OC-bbtr z0 I � by <br /> -t� (date,) A (month) (year) <br /> Ja Ju n as I�/10�rtr�ler <br /> (Na of permittee representative) (title) <br /> of <br /> �QZy 1�-��.r �►� � .�.�t Cb�n�� <br /> E <br /> RIE SULLIVAN (permittee)RY PUBLIC <br /> 20164000LOR 94DO <br /> #20164029410 <br /> xpim August 3,2020 NOTARY PUBLIC <br /> (seal) <br /> My Commission expires: <br /> �- 3-2o2v <br /> Page 3 of 6 <br />