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Agreement to Conduct Permitting by Electronic Means <br /> 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 /> AA �2--A,, <br /> Affi 1,k <br /> ant's name <br /> Signature <br /> Notarized Affidavit of Si nature <br /> STATE OF: ) <br /> COUNTY OF: ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this I day of 0 C „�/b by <br /> (date) (month) (year) <br /> as <br /> (Name of permittee representative) (title) <br /> of <br /> �Ld 56 S, LL C_ <br /> (permittee) <br /> CORIANOTRY PUBLICT RY IID 1974401TATE(OF �3343 NOTARY PUBLIMY::BARBARAJ. <br /> SSION EXPIRES JULY 25,2017 <br /> Malin <br /> (seal) <br /> My Commission expires: _ <br /> 7 <br /> Page 5 of 6 <br />