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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 /> - 0a y ' d C�'r <br /> Affiant's name <br /> Signature <br /> Notarized Affidavit of Signature <br /> STATE OF: II ) <br /> COUNTY OF: ) ss. <br /> 06,[off <br /> The foregoing instrument was acknowledged <br /> before me this 7 Z_ day of , 7ol U by <br /> (date) (month) (year) <br /> as <br /> ame of permittee representative) (t <br /> of <br /> (permittee) <br /> CASEY FAHRING <br /> NOTARY PUBLIC <br /> STATE OF COLORADO NOTA.AY PUBL <br /> NOTARY ID 20144009652 <br /> MY COMMISSION EXPIRES FEBRUARY 28,2018 <br /> (seal) <br /> My Commission expires: <br /> DZ-7k-1'j< <br /> Page 5 of 6 <br />